柳叶刀杂志恶性肿瘤手册,:淋巴瘤治疗对策新探寻

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柳叶刀杂志恶性肿瘤手册,:淋巴瘤治疗对策新探寻 。
印度的natco马法兰盘Melphalan摘 要:。柳叶刀杂志恶性肿瘤手册,:淋巴瘤治疗对策新探寻《柳叶刀肿瘤分册》2022年6月28日线上先给http://thelancet.com/journals/lanonc/article/PIIS1470-2045(17)30444-8/fulltext

在相对高度风险弥漫型大B体细胞淋巴癌中利妥昔单抗(美罗华)使用量聚集性有机化学治疗法加或不增加使用量有机化学治疗法协同自体干细胞移殖(DLCL04实验):一项多核心、对外开放标识、随机化对比3期科研的最后結果

环境年青的相对高度风险(年纪校准后国际性愈后指数值[aa-IPI]得分为2或三分)弥漫型大B体细胞淋巴肿瘤病患者用R-CHOP方式(利妥昔单抗、环磷酰胺、长春新碱、阿霉素和强的松)医治愈后差。本科学研究重在科学研究在这种病患者中做为一线医治的一部分,用大使用量有机化学治疗法 自体干细胞移殖开展加强医治所产生的很有可能获利状况。方式大家选用2 × 2析因设计,开展了一项多核心、对外开放标识、随机化对比、3期临床试验,在2种不一样的R-CHOP使用量水准,在相对高度风险大B体细胞淋巴肿瘤(aa-IPI得分2–3)年青(18-65岁)病患者中,对二种治疗方法开展了较为,一种方式为全过程利妥昔单抗使用量聚集性有机化学治疗法(无移殖组),另一种方式为近程利妥昔单抗使用量聚集性有机化学治疗法,条件随机场R-MAD(利妥昔单抗 大使用量阿糖胞苷 米托蒽醌 阿昔洛韦)和大使用量BEAM有机化学治疗法的推进医治,并协同自体干细胞移殖(移殖组)。入组时,依照aa-IPI得分对病患者开展分层次,任意将病患者开展排序(1:1:1:1),一组接纳R-CHOP方法治疗(d1天,静脉血管给375mg/m2的利妥昔单抗、750mg/m2环磷酰胺、50mg/m2多柔吡星、1.4mg/m2长春新碱,d1-5天,内服强的柳叶刀杂志恶性肿瘤手册,:淋巴瘤治疗对策新探寻松100毫克),14天一周期时间,共八个周期时间(R-CHOP-14组);一组接纳大使用量R-CHOP-14(R-大使用量CHOP-14方式,除开环磷酰胺1200mg/m2、多柔吡星70mg/m2之外,其他同R-CHOP-14方式)医治6个周期时间;一组接纳R-CHOP-14方法4个周期时间,条件随机场R-MAD方式(d1或四天,静脉血管给利妥昔单抗375mg/m2;d1-三天,每12小时静脉血管给阿糖胞苷2000mg/m2和阿昔洛韦4mg/m2;d1-三天,静脉血管给米托蒽醌8mg/m2) BEAM方式(d-7天,静脉血管给卡莫司汀300mg/m2;d-6至-三天,每日2次,静脉血管给阿糖胞苷200mg/m2;d-6至-三天,每日2次,静脉血管给依托泊苷100毫克/m2;d-2天静脉血管给马法兰盘140mg/m2) 自体干细胞移殖(d0天);一组接纳R-大使用量CHOP-14方法4个周期时间,条件随机场R-MAD BEAM和自体干细胞移殖。关键终端为在意向医治群体中2年无不成功存活概率。本分析在EudraCT(2005-002181-14; 2007-000275-42)和ClinicalTrials.gov注册网站,NCT00499018。結果2006年1月10日至2010年9月8日,将399名病患者随机分组,一组接纳移殖(n=199)、一组未接纳移殖(n=200);203名病患者分到接纳R-CHOP-14方式、196名份到接纳R-大使用量CHOP-14方式。负相关随诊72个月(IQR,57–88),移殖组2年无不成功存活概率为71%(95%CI,64-77),并非移殖组为62%(95%CI,55–68)(风险比[HR],0.65[95%CI,0.47-0.91],分层次log-rank检测,p=0.012)。5年总存活概率这种小组之间无差别(78%[95%CI,71-83]较为77%[71-83],HR,0.98[0.65-1.48],分层次log-rank检测,p=0.91)。移殖组199名病患者中有183名(92%)汇报了≥3级血液系统副作用,并非移殖组200名病患者中有135名(68%)。≥3级非血液系统副作用汇报了90名(45%)较为21名(16%),最普遍的≥3级非血液系统副作用为消化道副作用(49[25%]较为19[10%])。13名病患者(3%)产生医治相关联性过世,8名在移殖组、5名在非移殖组。表述在相对高度风险大B体细胞淋巴肿瘤年青病患者中,与全过程利妥昔单抗使用量聚集性有机化学治疗法对比,近程利妥昔单抗使用量聚集性有机化学治疗法 R-MAD BEAM和自体干细胞移殖降低了医治错误的风险,但这种效果很有可能沒有临床表现,由于这类改进并沒有体现出总存活概率有提升,在愈后欠佳的弥漫型大B体细胞淋巴肿瘤病患者中,这种結果不兼容进一步考虑到选用R-CHOP加强做为早期对策。《壹篇》南南和晨晨

Rituximab-dose-dense chemotherapy with or without high-dose chemotherapy plus autologous stem-cell transplantation in high-risk diffuse large B-cell lymphoma (DLCL04): final results of a multicentre, open-label, randomised, controlled, phase 3 study

BackgroundThe prognosis of young patients with diffuse large B-cell lymphoma at high risk (age-adjusted International Prognostic Index [aa-IPI] score 2 or 3) treated with R-CHOP (rituximab, cyclophosphamide, vincristine, doxorubicin, and prednisone) is poor. The aim of this study was to investigate the possible benefit of intensification with high-dose chemotherapy and autologous stem-cell transplantation as part of first-line treatment in these patients.MethodsWe did a multicentre, open-label, randomised, controlled, phase 3 trial with a 2 × 2 factorial design to compare, at two different R-CHOP dose levels, a full course of rituximab-dose-dense chemotherapy (no transplantation group) versus an abbreviated course of rituximab-dose-dense chemotherapy followed by consolidation with R-MAD (rituximab plus high-dose cytarabine plus mitoxantrone plus dexamethasone) and high-dose BEAM chemotherapy (carmustine, etoposide, cytarabine, and melphalan) plus autologous stem-cell transplantation (transplantation group) in young patients (18–65 years) with untreated high-risk diffuse large B-cell lymphoma (aa-IPI score 2–3). At enrolment, patients were stratified according to aa-IPI score and randomly assigned (1:1:1:1) to receive R-CHOP (intravenous rituximab 375 mg/m2, cyclophosphamide 750 mg/m2, doxorubicin 50 mg/m2, and vincristine 1·4 mg/m2 on day 1, plus oral prednisone 100 mg on days 1–5) delivered柳叶刀杂志恶性肿瘤手册,:淋巴瘤治疗对策新探寻 in a 14-day cycle (R-CHOP-14) for eight cycles; high-dose R-CHOP-14 (R-MegaCHOP-14; R-CHOP-14 except for cyclophosphamide 1200 mg/m2 and doxorubicin 70 mg/m2) for six cycles; R-CHOP-14 for four cycles followed by R-MAD (intravenous rituximab 375 mg/m2 on day 1 or 4 plus intravenous cytarabine 2000 mg/m2 and dexamethasone 4 mg/m2 every 12 h on days 1–3 plus intravenous mitoxantrone 8 mg/m2 on days 1–3) plus BEAM (intravenous carmustine 300 mg/m2 on day −7, intravenous cytarabine 200 mg/m2 twice a day on days −6 to −3, intravenous etoposide 100 mg/m2 twice a day on days −6 to −3, plus intravenous melphalan 140 mg/m2 on day −2) and autologous stem-cell transplantation (day 0); or R-MegaCHOP-14 for four cycles followed by R-MAD plus BEAM and autologous stem-cell transplantation. The primary endpoint was failure-free survival at 2 years in the intention-to-treat population. This study is registered with EudraCT (2005-002181-14; 2007-000275-42) and with ClinicalTrials.gov, number NCT00499018.FindingsBetween Jan 10, 2006, and Sept 8, 2010, 399 patients were randomly assigned to receive transplantation (n=199) or no transplantation (n=200); 203 patients were assigned to receive R-CHOP-14 and 196 were assigned to receive R-MegaCHOP-14. With a median follow-up of 72 months (IQR 57–88), 2-year failure-free survival was 71% (95% CI 64–77) in the transplantation group versus 62% (95% CI 55–68) in the no transplantation group (hazard ratio [HR] 0·65 [95% CI 0·47–0·91]; stratified log-rank test p=0·012). No difference in 5-year overall survival was observed between these groups (78% [95% CI 71–83] versus 77% [71–83]; HR 0·98 [0·65–1·48]; stratified log-rank test p=0·91). Grade 3 or worse haematological adverse events were reported in 183 (92%) of 199 patients in the transplantation group versus 135 (68%) of 200 patients in the no transplantation group. Grade 3 or worse non-haematological adverse events were reported in 90 (45%) versus 31 (16%); the most common grade 3 or worse non-haematological adverse event was gastrointestinal (49 [25%] vs 19 [10%]). Treatment-related deaths occurred in 13 (3%) patients; eight in the transplantation group and five in the no transplantation group.InterpretationAbbreviated rituximab-dose-dense chemotherapy plus R-MAD plus BEAM and autologous stem-cell transplantation reduced the risk of treatment failure compared with full course rituximab-dose-dense chemotherapy in young patients with diffuse large B-cell lymphoma at high risk. However, these results might not be clinically meaningful, since this improvement did not reflect an improvement in overall survival. These results do not support further consideration of the use of intensification of R-CHOP as an upfront strategy in patients with diffuse large B-cell lymphoma with poor prognosis.《壹篇》(与桓兴医讯同歩)系关键朝向医护人员的服务性【微信号码:yaodaoyaofang】,不因盈利为目地,不开展一切有偿服务资询和服务项目,不销售一切商品,与ASCO、CSCO等全部技术专业学好和组织并没有任何的关联和联络,都不意味着一切官方网学好发音。文章照片均来源于互联网,不做商业行为,若有著作权异议请与《壹篇》联络。不断关注点赞——【手机微信:india2080】、称赞和分享——【手机微信:india2080】是一种心态和适用。马法兰盘(ALPHALAN)Alphalan Melphalan Tablets 2mg 馬法蘭片 马法兰 药道全世界,助推性命。印度的全世界海淘药店:。

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