Rituximab plus cladribine versus R-CHOP in frontline management of marginal zone lymphoma in China: a propensity-score matched multicenter study

医学 美罗华 内科学 切碎 胃肠病学 长春新碱 发热性中性粒细胞减少症 国际预后指标 中性粒细胞减少症 弥漫性大B细胞淋巴瘤 淋巴瘤 外科 环磷酰胺 化疗
作者
Yawen Wang,Jiadai Xu,Jing Li,Zheng Wei,Miaojie Shi,Rong Tao,Bobin Chen,Yuzhou Tian,Wenhao Zhang,Yan Ma,Lin Sun,Yiling Hou,Qilin Zhan,Jigang Wang,Xue Hou,Peng Liu
出处
期刊:Annals of Hematology [Springer Nature]
卷期号:101 (10): 2139-2148
标识
DOI:10.1007/s00277-022-04919-3
摘要

Marginal zone lymphoma (MZL) is an uncommon subtype of non-Hodgkin lymphoma (NHL). Combination of rituximab and cladribine (R-2CdA) is a potential option for indolent NHL (iNHL) and mantle cell lymphoma (MCL) patients. The goal of this multicenter retrospective study was to assess the efficacy and safety of R-2CdA in MZL to support consensus-reaching in first-line therapy in advanced-stage patients. We searched electronic medical records databases of eight centers in China. Between November 2014 and December 2019, 183 symptomatic advanced MZL patients (42 treated with R-2CdA and 141 with rituximab plus cyclophosphamide, adriamycin, vincristine, and prednisone [R-CHOP]) were identified. After propensity score matching (PSM) (1:1) to adjust for clinical characteristics, 39 patients from each treatment arm were selected. The overall response rate (ORR) (84.6% vs. 94.9%, P = 0.263) and complete response rate (59.0% vs. 66.7%, P = 0.487) were comparable between two protocols. Neither progression-free survival (PFS), including the 5-year PFS (67.7% vs. 56.1%, P = 0.352), nor overall survival was improved by R-2CdA versus R-CHOP. However, R-2CdA was more tolerable than R-CHOP in MZL patients regarding grade 3/4 hematological adverse events (odds ratio [OR] 0.565, 95% confidence interval [CI] neutropenic fever (OR 0.795, 95% CI 0.678-0.932), and infections (OR 0.800, 95% CI 0.640-1.000). Overall, our study demonstrated that R-2CdA is potentially as effective as but safer than R-CHOP in advanced MZL.
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