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造血干细胞移植和 Brentuximab Vedotin 用于治疗复发或难治性霍奇金淋巴瘤和系统性间变性大细胞淋巴瘤患者。

Hematopoietic Stem Cell Transplantation and Brentuximab Vedotin for Patients with Relapsed or Refractory Hodgkin Lymphoma and Systemic Anaplastic Large-Cell Lymphoma.

机构信息

Division of Hematology and Cell Therapy, Department of Third Internal Medicine, Yamagata University Faculty of Medicine, Yamagata, Japan.

Japan Medical Affairs, Japan Oncology Business Unit, Takeda Pharmaceutical Company Limited, Tokyo, Japan.

出版信息

Adv Ther. 2019 Oct;36(10):2679-2696. doi: 10.1007/s12325-019-01046-w. Epub 2019 Aug 7.

Abstract

Brentuximab vedotin (BV) is an antibody-drug conjugate that has demonstrated effectiveness as a monotherapy for patients with relapsed or refractory Hodgkin lymphoma and systemic anaplastic large-cell lymphoma via several clinical trials. Salvage chemotherapy followed by autologous or allogeneic hematopoietic stem cell transplantation (HSCT) has been performed as a second- or later-line regimen for improving the survival of patients with lymphoma. In particular, the effectiveness of autologous HSCT and the importance of achieving a complete response prior to autologous HSCT are established in Hodgkin lymphoma. Several clinical trials have reported that salvage chemotherapy followed by autologous HSCT showed high response rates, although significant treatment-related hematological toxicity was observed. In the present article, we review clinical reports for assessing the efficacy and safety of relatively less toxic BV as a bridging therapy before HSCT or as a consolidation therapy post-HSCT in patients with relapsed or refractory Hodgkin lymphoma or systemic anaplastic large-cell lymphoma. Generally, the reported BV regimens seem to be effective and well tolerated in such patients, and no significant influence of BV treatment is noted on hematopoietic stem cell harvest before HSCT. Large-scale clinical studies and long-term follow-up are expected to establish the safety and efficacy of these regimens.Funding: Takeda Pharmaceutical Co., Ltd., Tokyo, Japan.

摘要

本妥昔单抗(BV)是一种抗体药物偶联物,通过多项临床试验已证明对复发或难治性霍奇金淋巴瘤和系统性间变性大细胞淋巴瘤患者作为单药治疗有效。挽救性化疗后自体或异基因造血干细胞移植(HSCT)已作为二线或更后线方案用于改善淋巴瘤患者的生存。特别是,自体 HSCT 的有效性和在自体 HSCT 前达到完全缓解的重要性在霍奇金淋巴瘤中已得到确立。几项临床试验报告称,挽救性化疗后自体 HSCT 显示出高反应率,尽管观察到显著的治疗相关血液学毒性。在本文中,我们复习了评估相对毒性较小的 BV 作为 HSCT 前桥接治疗或 HSCT 后巩固治疗在复发或难治性霍奇金淋巴瘤或系统性间变性大细胞淋巴瘤患者中的疗效和安全性的临床报告。一般来说,报告的 BV 方案在这些患者中似乎是有效且耐受良好的,并且在 HSCT 前采集造血干细胞时,BV 治疗没有明显影响。预计大规模的临床研究和长期随访将确立这些方案的安全性和有效性。

资助

武田药品工业株式会社,日本东京。

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