Impact of rituximab and half-dose CHOP as primary therapy for untreated symptomatic Waldenström Macroglobulinemia: review of a combined regimen of rituximab with an alkylating agent

Naohiro Sekiguchi; Airi Hamano; Tomoko Kitagawa; Yuya Kurihara; Kenichi Ito; Miwa Kurimoto; Kozo Watanabe; Kazuhiko Hirano; Satoshi Noto; Kazuaki Yamada; Naoki Takezako

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자료유형: 학술저널

저자정보: Naohiro Sekiguchi (National Hospital Organization Disaster Medical Center) Airi Hamano (National Hospital Organization Disaster Medical Center) Tomoko Kitagawa (National Hospital Organization Disaster Medical Center) Yuya Kurihara (National Hospital Organization Disaster Medical Center) Kenichi Ito (National Hospital Organization Disaster Medical Center) Miwa Kurimoto (National Hospital Organization Disaster Medical Center) Kozo Watanabe (National Hospital Organization Disaster Medical Center) Kazuhiko Hirano (National Hospital Organization Disaster Medical Center) Satoshi Noto (National Hospital Organization Disaster Medical Center) Kazuaki Yamada (National Hospital Organization Disaster Medical Center) Naoki Takezako (National Hospital Organization Disaster Medical Center)

저널정보: 대한혈액학회 Blood Research Blood Research Vol.53 No.2

발행연도: 2018.1

수록면: 117 - 122 (6page)

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Background Waldenström Macroglobulinemia (WM) is a rare subtype of indolent B-cell lymphoma, and prospective randomized studies on WM are scarce. The R-CHOP therapy [rituximab (R), cyclophosphamide, hydroxy-doxorubicin, vincristine, and prednisone] is a popular and recommended regimen for primary therapy, prescribed by several treatment guide-lines for WM. However, treatment with R-CHOP is accompanied by severe myelosup-pression and high rates of peripheral neuropathy. Therefore, we retrospectively evaluated the efficacy and toxicity of half-dose CHOP combined with R as a primary therapy for WM. Methods Patients with untreated symptomatic WM, treated at the Disaster Medical Center be-tween April 2011 and September 2016, were retrospectively analyzed after admin-istration of 6 cycles of half-dose R-CHOP for every 3 weeks. The response, median time to response, best response, progression-free survival, overall survival, and toxicities were evaluated. Results Of the 20 WM patients analyzed, 16 (80%) received half-dose R-CHOP without vincris-tine, and 13 (65%) responded to the treatment. With a median follow-up duration of 26.3 months, the 2-year progression-free survival and 2-year overall survival rates were 70 and 93.3%, respectively. The median time to response and best response were 6 and 9.9 weeks, respectively. Grade 3/4 leukocytopenia, neutropenia, febrile neutropenia, and Grade 1 peripheral neuropathy developed in 32, 37, 0, and 21% of patients, respectively. Conclusion The half-dose R-CHOP is an effective and well-tolerated primary therapy for WM. To the best of our knowledge, this is the first study reporting the use of a reduced-dose R-CHOP regimen for the primary treatment of WM.

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