Recent Advances in the Treatment of Lymphomas
E Tse, YL Kwong
Hong Kong J Radiol 2010;13(Suppl):S22-4
Malignant lymphoma is a common neoplasm and some are potentially curable if appropriate therapy is given. The use of the monoclonal anti-CD20 antibody rituximab in the management of follicular lymphoma has improved the outcome of patients. Rituximab and chemotherapy combination is now standard in the initial treatment of advanced-stage follicular lymphoma. Furthermore, rituximab maintenance therapy has also been shown to prolong progression-free survival in first clinical remission as well as in relapse following salvage therapy. In addition to rituximab, the use of purine analogue fludarabine in follicular lymphoma has also been shown to enhance the response rate. On the other hand, chemotherapy designed for the treatment of B-cell lymphoma is generally ineffective for NK/T-cell lymphoma, a highly malignant lymphoma that is prevalent in Asian countries. Recently, preliminary results from international study and our local centre have shown that the SMILE regimen (comprising dexamethasone, methotrexate, ifosphamide, L-asparaginase and etoposide) is very effective and would potentially improve the survival of patients with NK/T-cell lymphoma.
中文摘要
淋巴瘤治療的最新發展
謝偉財、鄺沃林
惡性淋巴瘤是一種很常見的腫瘤，施以適當的治療可以治癒部分的患者。使用抗CD20單克隆抗體利 妥昔單抗（rituximab）醫治濾泡性淋巴瘤有助改善病情。而rituximab結合化療已成為治療晚期濾泡 性淋巴瘤的第一線標準治療方法。此外，利妥昔單抗維持治療已被證實可為病情得到首發性緩和， 及經過搶救性治療的復發性濾泡性淋巴瘤病人延長無惡化生存期。除了利妥昔單抗，嘌呤類似物 fludarabine也可為濾泡性淋巴瘤患者加強療效。另一方面，專為B細胞淋巴瘤而設的化療通常對NK/T 細胞淋巴瘤（一種多見於亞洲地區的高度惡性淋巴瘤）無效。國際及本地研究最近得出的初步結 果均顯示SMILE方案（包括地塞米松、甲氨蝶呤、異環磷口胺、左旋天冬醯胺酶及依托泊苷）對於 NK/T細胞淋巴瘤患者很有效，並對改善病人的存活率有潛在價值。