脾边缘区B 细胞淋巴瘤是不是很少病友啊

雨人山

早晨之星 发表于 2019-5-18 10:37
您用的美罗华本身也是化疗药啊，只不过组合起来可能更快，但是缓解还是需要时间的，即使脾恢复的再快
...

美罗华不是化疗药。缓解点是病灶消失，和没有出现新病灶。就是检验不出来淋巴瘤细胞了。脾缩下去与否跟缓解不是一个概念。也就是说，完全缓解的时候脾可能还是大的，但淋巴瘤细胞已经没有了。

我记着读过一篇文章单打美罗华就可以让44%左右的脾边缘带淋巴瘤患者出现分子级缓解。[size=0.8465em]Hematol Oncol. 2007 Sep;25(3):127-31.
Rituximab monotherapy is highly effective in splenic marginal zone lymphoma.[size=0.923em]Kalpadakis C[size=0.8461em]1, Pangalis GA, Dimopoulou MN, Vassilakopoulos TP, Kyrtsonis MC, Korkolopoulou P, Kontopidou FN, Siakantaris MP, Dimitriadou EM, Kokoris SI, Tsaftaridis P, Plata E, Angelopoulou MK.
Author information

Abstract

[size=1.04em]Splenectomy has traditionally been considered as a standard first line treatment for splenic marginal zone lymphoma (SMZL) conferring a survival advantage over chemotherapy. However it carries significant complications, especially in elderly patients. The purpose of this retrospective study was to report our experience on the efficacy of Rituximab as first line treatment in 16 consecutive SMZL patients, diagnosed in our department. The diagnosis was established using standard criteria. Patients' median age was 57 years (range, 48-78). Prior to treatment initiation all patients had splenomegaly, nine had anemia, five lymphocytosis, five neutropenia and six thrombocytopenia. Rituximab was administered at a dose of 375 mg/m2/week for 6 consecutive weeks. The overall response rate was 100%. After treatment, all patients had a complete resolution of splenomegaly along with restoration of their blood counts. Eleven patients (69%) achieved a CR, three (19%) unconfirmed CR and two (12%) a PR. Among the complete responders seven patients had also a molecular remission. The median time to clinical response was 3 weeks (range, 2-6). Rituximab maintenance was given to 12 patients. Eleven of them had no evidence of disease progression after a median follow-up time of 28.5 months (range, 14-36), while two out of four patients who did not receive maintenance, relapsed 7 and 24 months after the completion of induction treatment. Median follow-up time for the entire series was 29.5 months (range, 15-81). No deaths were recorded during the follow-up period. Therapy was well tolerated. The present study demonstrates that rituximab is an effective treatment for SMZL and could be considered as a substitute or alternative to splenectomy.

[size=0.93em]2007 John Wiley & Sons, Ltd.

早晨之星

雨人山 发表于 2019-5-18 10:59
美罗华不是化疗药。缓解点是病灶消失，和没有出现新病灶。就是检验不出来淋巴瘤细胞了。脾缩下去与否跟缓 ...