Abstract
Introduction. Immunochemotherapy is an obligate component in treatment of follicular lymphoma (FL). Monoclonal antibodies to CD20 antigen is the most well studied and frequently used drug. Chemotherapy department of Russian Cancer Research Center has a very good experience in FL treatment using rituximab. In the article we characterize and compare two methods of treatment of FL - polychemotherapy vs chemotherapy. Materials and methods. 286 patients with FL were included into analysis. In 125 (44 %) from 286 patients polychemotherapy was used as a first line of FL treatment. In 161 (56 %) patients rituximab was added to chemothrepy regimens. Analysis of survival and disease-free survival was done according to Kaplan-Meier. Analysis of treatment results has been done according to international criteria of treatment response in non-Hodgkin’s lymphomas. In statistical calculations SPSS program for Windows was used. Results. Responses to treatment were significantly better in immunochemotherapy group of patients, p = 0,002. In unifactorial analysis rituximab significantly improved both overall and disease-free sirvival. Taking in mind that groups of patients receiving chemotherapy and immunochemotherapy were not completely identical we performed multifactorial analysis, Coxs regression analysis. In that case (Cox regression analysis) significant advantages of immunochemotherapy were noted in improving disease-free survival in FL patients (р = 0,000); significant influence on overall survival was not noted (p = 0,44). Addition of rituximab did not improved overall and disease-free survival in a group (n = 88; 31 %) of refractory and early relapsing FL. Conclusion. Addition of rituximab to polychemotherapy in FL patients significantly improved treatment results. In multifactorial analysis immunochemotherapy was the most important prognostic factors of favourable prognosis of disease-free survival. In that analysis rituximab did not influenced on overall survival and on survival in refractory and early relapsing FL.
Highlights
Immunochemotherapy is an obligate component in treatment of follicular lymphoma (FL)
In 125 (44 %) from 286 patients polychemotherapy was used as a first line of FL treatment
Analysis of treatment results has been done according to international criteria of treatment response in non-Hodgkin’s lymphomas
Summary
В отделении химиотерапии гемобластозов накоплен большой опыт лечения больных ФЛ с использованием ритуксимаба. Непосредственные результаты лечения оказались достоверно лучшими в группе ИХТ, р = 0,002. При проведении однофакторного анализа получены данные о достоверном положительном влиянии добавления ритуксимаба как на ОВ, так и на ВБП. При проведении многофакторного анализа отмечены достоверные преимущества добавления ритуксимаба к ПХТ в виде улучшения ВБП, р = 0,000; достоверного влияния на сроки жизни больных ФЛ не отмечено (р = 0,44). Добавление ритуксимаба не оказывало существенного положительного влияния на сроки жизни и ВБП у больных (n = 88; 31 %) с нетипичным течением ФЛ (отсутствие ответа на терапию первой линии и развитие ранних рецидивов). Добавление ритуксимаба к схемам ПХТ у больных ФЛ существенно улучшает результаты лечения. Именно ИХТ явилась решающим фактором благоприятного прогноза, улучшающим ВБП у больных ФЛ.
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