侵袭性B细胞淋巴瘤新的标准治疗方案

New standard treatment for aggressive non-Hodgkin's lymphoma

实施CHOP方案（环磷酰胺、阿霉素、长春新碱和泼尼松）治疗20多年来。侵袭性B细胞淋巴瘤已成为可治愈的疾病，CHOP方案也已成为治疗这一疾病的标准方案。但其治愈率只有35％-40％，半数以上复发。随着抗B细胞表面抗原CD20的人鼠嵌合型单克隆抗体利妥昔（rituximab）的应用，侵袭性B细胞淋巴瘤的治疗已发生了根本改变。多项大型Ⅲ期随机临床研究结果证实，利妥昔与CHOP方案或CHOP样方案联合应用，比单纯联合化疗能明显改善侵袭性B细胞淋巴瘤的有效率，无事件生存和长期生存结果，无论是老年或年轻患者，低危预后还是高危预后患者，均有显著的统计学差异。因此，利妥昔加CHOP或CHOP样方案的联合治疗已成为侵袭性B细胞淋巴瘤新的标准治疗方案。

Abstract Diffuse large B - cell lymphoma （DLBCL） is the most common type of aggressive non -Hodgkin＇s lymphomas （NHL）. In the past more than two decades, CHOP chemotherapy （cyclophosphanide, doxorubin, vincreastine, prednisone ） had been the gold standard treatment for aggressive non- Hodgkin＇s lymphoma （NHL）. CHOP is only curative in approximately 35 % - 45 % of patients with DLBCL, therefore improved treatment are required. But so far, attempts to improved on CHOP chemotherapy had been unsuccessful. However, The chimeric anti - CD20 monoclonal antibody rituximab combination with CHOP or CHOP- like immunochemotherapy has now emerged as a new standard first - line treatment for patients with aggressive NHL, on the basis of significantly improved event - free and overall survival observed in the GELA LNH 98.5 study in elderly patients and the Mabthera International Trial evaluating R- CHOP versus （or CHOP - like chemotherapy） in young patients with aggressive NHL and DSHNHL1999 - 2001 RICOVER60 study.