Márquez MZN, Nieto CMA

Language: Spanish
References: 15
Page: 17-22
PDF size: 62.99 Kb.

ABSTRACT

The Non-Hodgkin’s Lymphoma treatment has not changed since the last 20 years. The standard treatment is known as Rituximab and CHOP Chemotherapy. Rituximab is a directed monoclonal antibody against antigen CD20, the association of this monoclonal antibody with conventional chemotherapy CHOP (Cyclophosphamide, Doxorubicin, Vincristine and Prednisone) has demonstrated a good response and a significant increase in the patient’s survival. It was made a longitudinal prospective study at the ISSSTE “General Ignacio Zaragoza” Regional Hospital, including 60 patients in a period of time of 5 years in order to determine Treatment Responses and Disease Free Survival Values. Patients were classified according with the Ann Arbor Stage and with the International Prognostic Index (IPI), histopathological samples and antigenic CD20 determinations were obtained. It was employed the Rituximab and CHOP scheme that consisted in 8 doses of each one. As final hematological results we had 90% patients with Complete Remission (54 patients) and 10% with Relapse (6 patients). Nowadays 98.3% patients continue in Remission (59 patients) and the survival continues with a 100% value (60 patients) in a time period of 5 years. The treatment scheme of Rituximab + CHOP in patients with Non-Hodgkin’s Lymphoma offers an effective alternative, a suitable tolerance, an optimal security profile and a significant increase in the disease free survival period.

REFERENCES

1. Hainsworth JD, Litchy S. Increasing chemotherapy intensity in aggressive lymphomas: A Renewal? Journal of Clinical Oncology 2003; 21: 2457-2459.

2. Cheson B. Report of an international workshop to standardize response criteria for Non-Hodgkin’s Lymphoma NCI sponsored international working group. J Clin Oncology 1999; 17: 1244-53.

3. Jemal A, Murray T, Samuels A et al. Cancer statistics, 2003. CA, Cancer Journal Clinical 2003; 53: 5-26.

4. Lewington VJ. Targeted radionuclide therapy for neuroendocrine tumors. Endocrine-Related Cancer 2003; 10(4): 497-501.

5. Jaffe E, WB Sanders. Histopathology of the Non-Hodgkin Lymphomas and Hodgkin disease. The Lymphomas 1998; 5: 77-106.

6. Herold M, Pasold R, Srock S et al. Results of a prospective randomized open label phase III study comparing rituximab plus mitoxantrone, chlorambucile, prednisolone chemotherapy (RMCP) versus MCP alone in untreated advanced indolent Non-Hodgkin lymphoma (NHL) and Mantle cell lymphoma (MCL). Blood 2004; 104: 584a (abstract).

7. Mc. Laughlin P, Grillo-López AJ, Link BK, Levy R, Czuczman MS, Williams ME et al. Rituximab chimerical anti CD20 monoclonal antibody therapy for relapsed indolent lymphoma: half of patients respond to a four-dose treatment program. J Clin Oncology 1998; 16: 2825-33.

8. Ghielmini M, Schmitz SE, Cogliatti SB, Pichert G, Hummerjohann J, Waltzer U et al. Prolonged treatment with rituximab in patients with follicular lymphoma significantly increases event free survival and response duration compared with standard weekly X schedule. Blood 2004; 103: 4416-23.

9. Sebban C, Belanger C, Brousse N et al. Comparison 14 of CHVP + interferon with CHOP followed by autologous stem cell transplantation with a TBI conditioning regimens in untreated patients with high tumor burden follicular lymphoma: Results of the randomized GEL94 trial (G.E.L.A: Study Group) Blood 2003; 102: 354a.

10. López-Guillermo A, Cabanillas F, McLaughlin P et al. The clinical significance of molecular response in indolent follicular lymphomas. Blood 1998; 91: 2955.

11. Burris HA III, Scullin DC Jr, Corso SW et al. Rituximab as first-line and maintenance therapy for patients with indolent Non-Hodgkin’s lymphoma. Journal of Clinical Oncology 2002; 20(20): 4261-426.

12. Cersosimo RJ. Monoclonal antibodies in the treatment of cancer, part 1. American Journal Health-Syst Pharm 2003; 60: 1531-1548.

13. Witzig TE, Vukov AM, Habermann TM, Geyer S, Kurtin PJ et al. Welker rituximab therapy for patients with newly diagnosed, advanced-stage, follicular Grade I Non-Hodgkin’s Lymphoma: A phase II trial in the North Central Cancer Treatment Group. Journal of Clinical Oncology 2005; 23: 2005.

14. Gordan LN, Grow WB, Pusateri A, Douglas V, Mendenhall NP, Lynch JW. Phase II trial of individualized rituximab dosing for patients with CD20-positive lymphoproliferative disorders. Journal of Clinical Oncology 2005; 23: 6-20.

15. Berinstein NL, Grillo-López AJ, White CA et al. Association of serum rituximab concentration antitumor response in the treatment of recurrent low-grade or follicular non-Hodgkin’s lymphoma. Ann Oncol 1998; 9: 995-1001.