单独使用利妥昔单抗是预治疗过的多毛细胞白血病患者的有效治疗方法。
Single-agent rituximab is an effective salvage therapy in pretreated hairy cell leukemia patients.
发表日期：2023 Sep 22
作者：
Alessandro Broccoli, Lisa Argnani, Laura Nanni, Vittorio Stefoni, Cinzia Pellegrini, Beatrice Casadei, Gabriele Gugliotta, Matteo Carella, Paolo Elia Coppola, Gianmarco Bagnato, Pier Luigi Zinzani
来源：
Blood Advances
摘要：
在多次嘌呤类似物治疗后复发的毛细胞白血病（HCL）患者中，如果嘌呤类似物有禁忌症（例如，骨髓细胞性差，高疾病浸润预示持久性再障）并且新药物（moxetumomab或vemurafenib）不容易获得，单药利妥昔单抗可作为一种合适的治疗方法。我们回顾了接受单药利妥昔单抗作为拯救疗法的患者的机构系列病例。患者每周以标准剂量375 mg/m2连续4周接受利妥昔单抗治疗。主要研究目标是总体反应率（ORR），下一次治疗的时间（TTNT），无进展生存期（PFS）和总生存期（OS）。根据共识解析标准对反应进行了分类。共有33名患者接受了39个利妥昔单抗疗程（4名患者接受了两次疗程，1名患者接受了三次疗程），作为中位数第三线疗法（范围为2-8）。在39个疗程中，完全缓解率为28.2％，部分缓解率为23.1％，最低限度缓解率为20.5％，无反应率为28.2％。中位TTNT为33个月（2年时为65％），中位PFS为24个月（2年时为51％），中位OS为154个月（20年时为22％）。据我们所知，这是接受单药利妥昔单抗治疗疾病复发的HCL患者中最广泛的系列病例。利妥昔单抗在经过嘌呤类似物治疗失败的经过预先治疗的HCL患者中是一种有效的拯救疗法。如果没有可行的替代方案，可以重复使用。Copyright © 2023 American Society of Hematology.
Single-agent rituximab can be a suitable treatment in hairy cell leukemia (HCL) patients relapsing after repeated courses of purine analogs, if purine analogs are contraindicated (e.g. in case of poor marrow cellularity, high disease infiltration predicting long-lasting aplasia) and if newer agents (moxetumomab or vemurafenib) are not easily available. Our institutional series of patients receiving single-agent rituximab as salvage therapy was reviewed. Patients received rituximab at the standard dose of 375 mg/m2 weekly for 4 weeks. The main study objectives were overall response rate (ORR), time-to-next treatment (TTNT), progression-free survival (PFS) and overall survival (OS). Responses have been categorized according to the Consensus Resolution Criteria. Thirty-three patients received 39 courses of rituximab (4 patients received it twice, one patient three times), as a median third line of therapy (range 2-8). Out of 39 courses, a complete response was obtained in 28.2% of cases, a partial response in 23.1% and a minimal response in 20.5%. In 28.2% of patients, we observed no response. Median TTNT was 33 months (65% at 2 years), median PFS was 24 months (51% at 2 years) and median OS resulted of 154 months (22% at 20 years). To our knowledge, this is the widest series of HCL patients receiving single-agent rituximab for disease relapse. Rituximab is an effective salvage therapy in pretreated HCL patients after failure of purine analogs. It may be repeated if no alternatives are available.Copyright © 2023 American Society of Hematology.