FLUDARABIN, CIKLOFOSFAMID I RITUKSIMAB (FCR) U LIJEČENJU BOLESNIKA S KRONIČNOM LIMFOCITNOM LEUKEMIJOM (KLL): ISKUSTVO KLINIČKOGA BOLNIČKOG CENTRA ZAGREB

Autor: Ivan Krečak, Sandra Bašić-Kinda, Dino Dujmović, Ida Hude, Ivo Radman-Livaja, Klara Dubravčić, Koraljka Gjadrov Kuveždić, Ivana Ilić, Igor Aurer
Jazyk: chorvatština
Rok vydání: 2017
Předmět:
Kronična limfocitna leukemija – farmakoterapija
komplikacije
Vidarabin – analozi i derivati
način uporabe i doziranje
nuspojave
terapijska primjena
Ciklofosfamid – način uporabe i doziranje
nuspojave
terapijska primjena
Rituksimab – način uporabe i doziranje
nuspojave
terapijska primjena
Protutumorski lijekovi – način uporabe i doziranje
nuspojave
terapijska primjena
Kombinirani protutumorski kemoterapijski protokoli – način uporabe i doziranje
nuspojave
terapijska primjena
Ishod liječenja
Indukcija remisije
Preživljenje bez progresije bolesti
Leukemia
lymphocytic
chronic
B-cell – complications
drug therapy
Vidarabine – administration and dosage
adverse effects
analogs and derivatives
therapeutic use
Cyclophosphamide – administration and dosage
adverse effects
therapeutic use
Rituximab – administration and dosage
adverse effects
therapeutic use
Antineoplastic agents – administration and dosage
adverse effects
therapeutic use
Antineoplastic combined chemotherapy protocols – administration and dosage
adverse effects
therapeutic use
Treatment outcome
Remission induction
Disease-free survival
Zdroj: Liječnički vjesnik
Volume 139
Issue 7-8
ISSN: 1849-2177
0024-3477
Popis: U kliničkim je studijama kombinacija fludarabina, ciklofosfamida i rituksimaba (FCR) pokazala odlične rezultate u liječenju bolesnika s kroničnom limfocitnom leukemijom (KLL) i postala zlatni standard u prvoj liniji liječenja takvih bolesnika bez znatnijih komorbiditeta. Cilj rada bio je ispitati terapijsku djelotvornost, toksičnost i provedivost ovog protokola u svakodnevnoj kliničkoj praksi. Retrospektivno su analizirani tijek i ishodi liječenja 43-oje bolesnika s KLL-om sa Zavoda za hematologiju Klinike za unutarnje bolesti Kliničkoga bolničkog centra Zagreb. Shema primjene rituksimaba razlikovala se od one u kliničkim studijama; primjenjivan je infuzijski u dozi od 375 mg/m2 u svim ciklusima, u ukupno osam doza u prvoj, odnosno šest u kasnijim linijama liječenja. Na liječenje je odgovorilo 95% bolesnika, a 83% postignulo je kompletnu remisiju. Trogodišnje preživljenje i preživljenje bez progresije bolesti u prvoj liniji liječenja (29 bolesnika) bilo je 90 i 80%, a u kasnijim linijama 86 i 62%. Teške neutropenije zabilježene su u 46% bolesnika, a teške infekcije u 9% bolesnika. Ishodi liječenja i toksični profil u svakodnevnome kliničkom radu usporedivi su s onima iz kliničkih studija
In clinical trials the combination of fludarabine, cyclophosphamide and rituximab (FCR) demonstrated superior results and became the gold standard for first-line treatment of fit patients with chronic lymphocytic leukemia (CLL). The aim of this study was to evaluate the efficacy, toxicity and feasibility of this protocol in everyday clinical practice. We ­retrospectively analyzed the outcomes of 43 CLL patients treated at the Division of Haematology, Department of Internal Medicine, University Hospital Centre Zagreb. The dosing of rituximab differed from that in clinical trials, we administered 375mg/m2 of rituximab per cycle, in previously untreated patients for eight and in relapsed/refractory patients for six cycles. The response rate was 95% with 83% of complete remissions. Twenty–nine patients received FCR as a front–line therapy; three-year overall and progression–free survival were 90% and 80%, respectively. In relapsed/refractory disease three–year overall and progression–free survival were 86% and 62%, respectively. Severe neutropenias occurred in 46% and serious infections in 9% of patients. According to these results, the toxicity profile and treatment outcomes in everyday routine clinical practice are similar to those reported in clinical trials.
Databáze: OpenAIRE
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