SUVREMENI PRISTUP NE-HODGKINOVU LIMFOMU PLAŠTENE ZONE: PREGLED LITERATURE
| Autor: | Vibor, Milunović, Martina Bogeljić, Patekar, Inga Mandac, Rogulj, Ana, Planinc-Peraica, Slobodanka Ostojić, Kolonić |
|---|---|
| Jazyk: | chorvatština |
| Rok vydání: | 2016 |
| Předmět: |
Limfom plaštene zone – liječenje
smrtnost Protutumorski kombinirani kemoterapijski protokoli – terapijska primjena neželjeni učinci Transplantacija krvotvornih matičnih stanica Autologna transplantacija Rituksimab – terapijska primjena Bendamustin – terapijska primjena Pirazoli – terapijska primjena Pirimidini – terapijska primjena Citarabin – terapijska primjena Biološko liječenje – metode Recidiv Indukcija remisije Ishod liječenja Treatment Outcome Antineoplastic Combined Chemotherapy Protocols Secondary Prevention Disease Management Humans Lymphoma mantle-cell – therapy mortality Antineoplastic combined chemotherapy protocols – therapeutic use adverse effects Hematopoietic stem cell transplantation Transplantation autologous Rituximab – therapeutic use Bendamustine hydrochloride – therapetic use Pyrazoles – therapetic use Pyrimidines – therapetic use Cytarabine – therapeutic use Biological therapy – methods Recurrence Remission induction Treatment outcome Lymphoma Mantle-Cell |
| Zdroj: | Liječnički vjesnik Volume 138 Issue 11-12 |
| ISSN: | 1849-2177 0024-3477 |
| Popis: | Limfom plaštene zone (engl. Mantle cell lymphoma – MCL) četvrti je najučestaliji ne-Hodgkinov limfom. Karakteriziran je agresivnim tokom s multiplim relapsima. Cilj je rada literaturnim pregledom opisati suvremeni pristup liječenju ovog limfoma. U mlađih bolesnika zlatni je standard intenzivna kemoterapija visokim dozama citarabina. Pri kompletnoj ili parcijalnoj remisiji kao konsolidacija je indicirana autologna transplantacija perifernih matičnih stanica. U starijih bolesnika kemoterapija CHOP-R-om nije prikladno rješenje. Ove bolesnike treba liječiti bendamustinom u kombinaciji s rituksimabom. Pri kompletnoj ili parcijalnoj remisiji opcija je konsolidacija odgovora održavanjem rituksimabom. Većina će bolesnika s MCL-om relabirati pa je njihovo liječenje izazov i teškoća u daljnjim postupcima. Liječenje relapsnog MCL-a može se podijeliti u dvije skupine: kemoterapija i biološki lijekovi. U bolesnika s dobrim općim statusom prikladna može biti kemoterapija temeljena na bendamustinu i citarabinu. U bolesnika s komorbiditetima moguća je opcija biološka terapija. Od biološke terapije treba istaknuti ibrutinib, inhibitor Brutonove kinaze, zbog najveće stope odgovora i trajanja učinka liječenja. S razvojem novih potentnih inhibitora B-staničnoga receptorskog puta aktivnih u MCL-u uskoro bi biološki lijekovi mogli postati zlatnim standardom i uvesti liječenje MCL-a u eru bez kemoterapije. Mantle cell lymphoma (MCL) represents the fourth most common type of non-Hodgkin lymphomas. It is characterized by aggressive course and frequent relapses. The main aim of this review is to evaluate current treatment approach towards this type of lymphoma. In younger patients the chemotherapy including high doses of cytarabine is the gold standard. In case of complete or partial remission, the consolidation with autologous stem cell transplantation is indicated as consolidation approach. In older patients CHOP-R regimen is not the treatment of choice. These patients should be treated with bendamustine in combination with rituximab. In case of complete or partial remission, further therapy with rituximab maintenance as consolidation represents an option. The vast majority of patients with MCL will ultimately relapse which poses a challenge in treatment approach. The approach in relapsed MCL can be divided in two types: chemotherapy or biologic therapy. In young fit patients chemotherapy based on bendamustine and cytarabine is a reasonable option. In patients with comorbidities or poor performance status biologic agents are reasonable options. Ibrutinib, Bruton kinase inhibitor, is characterized by highest overall response rate and the longest duration of response and should be offered to these patients. With the development of novel potent inhibitor of B cell receptor signaling pathway, these agents may become the gold standard in future and introduce the treatment of MCL in „chemo-free“era. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|