Centre Hospitalo-Universitaire Grenoble, France.
Br J Haematol. 2010 Oct;151(2):159-66. doi: 10.1111/j.1365-2141.2010.08329.x. Epub 2010 Aug 25.
Peripheral T-Cell lymphomas (PTCL) are relatively rare diseases but appear to be highly aggressive and display worse remission and survival rates than B-cell lymphomas. Despite unsatisfactory results with the cyclophosphamide, doxorubicin, vincristine, prednisone (CHOP) regimen, it remains the reference front-line therapy in these diseases, but has not been challenged in phase III trials. The Groupe Ouest Est d'Etude des Leucémies et Autres Maladies du Sang (GOELAMS) devised an alternative therapeutic schedule including etoposide, ifosfamide, cisplatin alternating with doxorubicin, bleomycin, vinblastine, dacarbazine (VIP-reinforced-ABVD; VIP-rABVD) and compared it to CHOP/21 as front-line treatment in non-cutaneous PTCL. All newly diagnosed patients were eligible. The primary objective was to improve the 2-year event-free survival (EFS) rate. Secondary objectives were to compare the response rate, overall survival, and toxicities as well as identify prognostic factors. Eighty-eight patients were identified between 1996 and 2002. Both arms were well balanced for patients' characteristics in terms of histological and clinical presentation. No significant difference was observed between the two arms in terms of 2-year EFS. Anaplastic large cell lymphoma type and Ann Arbor stage I-II were identified as two independent favourable prognostic factors influencing survival. VIP-rABVD was not superior to CHOP/21 in terms of EFS as first-line treatment of PTCL, confirming that CHOP/21 remains the reference regimen in these lymphomas.
外周 T 细胞淋巴瘤(PTCL)相对罕见,但似乎具有高度侵袭性,缓解率和生存率均较 B 细胞淋巴瘤差。尽管环磷酰胺、多柔比星、长春新碱、泼尼松(CHOP)方案的结果不尽人意,但它仍然是这些疾病的参考一线治疗方法,但在 III 期试验中并未受到挑战。Groupe Ouest Est d'Etude des Leucémies et Autres Maladies du Sang(GOELAMS)设计了一种替代治疗方案,包括依托泊苷、异环磷酰胺、顺铂与多柔比星、博来霉素、长春碱、达卡巴嗪交替使用(VIP 强化-ABVD;VIP-rABVD),并将其与 CHOP/21 进行比较,作为非皮肤性 PTCL 的一线治疗。所有新诊断的患者均符合条件。主要目标是提高 2 年无事件生存率(EFS)。次要目标是比较反应率、总生存率和毒性,以及确定预后因素。1996 年至 2002 年间共确定了 88 例患者。两组患者在组织学和临床表现方面的特征均平衡良好。两组患者在 2 年 EFS 方面无显著差异。间变性大细胞淋巴瘤类型和安阿伯分期 I-II 被确定为两个独立的有利预后因素,影响生存。在作为 PTCL 的一线治疗时,VIP-rABVD 在 EFS 方面并不优于 CHOP/21,这证实了 CHOP/21 仍然是这些淋巴瘤的参考方案。