Introduction to mantle cell lymphoma

  约克郡的一项研究表明，由于引入了新的靶向药物，过去十年中，一种高侵略性的血癌的生存时间几乎翻了一番。   约克大学和NHS的临床医生在2004年至2015年期间跟踪了约克郡和亨伯赛德郡各医院335名套细胞淋巴瘤（MCL）患者的治疗情况。在此期间，新诊断的患者的生存时间平均从两年增加到三年半。   这项研究由血癌研究慈善机构Bloodwise资助，发表在《英国血液学杂志》上。   在英国，每年约有500人被诊断为MCL。进行研究的约克和NHS研究人员证实，在初始化疗与利妥昔单抗相结合后，生存时间得到了改善，利妥昔单抗是一种利用病人的免疫系统攻击癌细胞的药物。   不幸的是，几乎所有MCL患者都会复发，需要进一步治疗。直到最近，除了进一步强化化疗外，几乎没有其他治疗选择，而化疗往往不是很有效，而且经常有严重的副作用。   事实表明，新疗法的引入，包括化疗药物苯达莫司汀，以及靶向非化疗药物伊布替尼，大大改善了之前化疗后复发的患者的生存率。伊布替尼通过靶向并关闭一种与套细胞淋巴瘤癌细胞的生长和运动有关的蛋白质而起作用。本达莫司汀通过干扰癌细胞中的DNA，防止它们繁殖而起作用。   存活时间从2004-11年复发的病人的8个月增加到2012-15年复发的病人的17个月。自2004年以来，70岁以上的患者在复发后存活一年或更长时间的人数几乎翻了一番–这表明新的靶向药物的引入正在使那些无法接受强化治疗的老年患者受益。   这项研究由血液学恶性肿瘤研究网络（HMRN）进行，约克郡和亨伯赛德郡14家医院的临床医生和约克大学的流行病学家合作进行。   约克大学健康科学系的Russell Patmore教授说。”虽然与其他类型的淋巴瘤相比，套细胞淋巴瘤患者的前景仍然相对较差，但我们的研究表明，新疗法的引入已经改善了生存时间。这项研究表明，监测治疗变化的影响以了解它们是否产生了作用是非常重要的，特别是在难以进行大规模临床试验的较罕见的癌症形式中。”   血癌研究慈善机构Bloodwise的研究通讯经理Liz Burtally说。”几十年的研究已经导致开发出越来越多的血癌靶向药物。虽然套细胞淋巴瘤患者的前景仍然相对较差，但这些新药物可以为人们的生活带来宝贵的几个月或几年。这项重要的研究显示了新的治疗方法和治疗组合在哪些方面对患者有效，以及哪些方面可以改进”。   HMRN按照临床试验的标准，采集了约克郡和亨伯赛德郡每个被诊断为血癌患者的治疗、反应和结果的详细数据。因为这个地区的人口与英国整体的特征相似，这意味着研究结果适用于全国的患者。所有的诊断都是由利兹市圣詹姆斯医院血液学恶性肿瘤诊断服务部的临床专家进行的，并按照世界卫生组织的最新分类进行编码。自2004年HMRN成立以来，Bloodwise一直资助该机构。 本文来源于互联网，如有侵权请联系删除。来源：https://medicalxpress.com/news/2018-06-drugs-survival-patients-aggressive-blood.html

Introduction Mantle cell lymphoma accounts for 6% of all non-Hodgkin lymphoma (NHL). Differential diagnosis of mantle cell lymphoma includes other small cell B cell lymphomas. The most common manifestation of mantle cell lymphoma is swollen lymph nodes, often accompanied by systemic symptoms. Blood pathologists based on morphological findings and the tumor is a B-cell lymphoma, making a correct diagnosis of mantle cell lymphoma. As with other subtypes of lymphoma, a suitable biopsy is important. The treatment of mantle cell lymphoma CHOP regimen was not satisfactory, and only a few patients achieved complete remission. The basic content of the set of cell lymphoma disease sets of cell lymphoma accounted for 6% of all non-Hodgkin's lymphoma (NHL). This type of lymphoma was previously classified in other subtypes and has only been recognized as an independent disease for more than a decade. Recognizing that these lymphomas have characteristic chromosomal translocation t(11;14), that is, the shift between the immunoglobulin heavy chain gene on chromosome 14 and the Bcl-1 gene on chromosome 11, regularly overexpressing Bcl The -1 protein, the most characteristic is the overexpression of Cyclin D1, thus confirming the existence of this type of lymphoma. The most common manifestation of clinical manifestations of mantle cell lymphoma is swollen lymph nodes, often accompanied by systemic symptoms. Almost 70% of patients are diagnosed with stage III or IV disease, often with bone marrow and peripheral blood infiltration. Extranodal organs may be invaded, and gastrointestinal invasion is particularly important for understanding the disease. Patients with lymphoma polyp lesions in the large intestine often have mantle cell lymphoma. Patients with gastrointestinal invasion often have pharyngeal lymphatic invasion and so on. Diagnostic blood pathologists based on morphological findings and the tumor is a B-cell lymphoma, making a correct diagnosis of mantle cell lymphoma. As with other subtypes of lymphoma, a suitable biopsy is important. Differential diagnosis of mantle cell lymphoma includes other small cell B cell lymphomas. Special sets of cell lymphomas and small lymphocytic lymphomas have characteristic CD5 expression. Mantle cell lymphoma often has a serrated nucleus. Treatment of mantle cell lymphoma CHOP regimen is not satisfactory, and only a few patients achieve complete remission. Enhanced combination chemotherapy regimens (such as HyperCVAD/MTX-AraC and EPOCH) are often associated with younger patients with autologous or allogeneic bone marrow transplantation. Several international clinical trials have shown that combined use of rituximab (R) and chemotherapy have better clinical outcomes, so R-HyperCVAD/MTX-AraC, R-EPOCH, R-CHOP and rituximab are currently recommended. Combined with cladribine and the like as a first-line treatment. Considering hematopoietic stem cell transplantation as a first-line consolidation therapy for young patients. Rituximab combined with thalidomide shows better clinical outcome and can be used as a second-line treatment. The proteasome inhibitor bortezomib has shown initial efficacy in the treatment of relapsed mantle cell lymphoma and can also be used as a second-line treatment. The 5-year survival rate of prognostic mantle cell lymphoma is about 25%. The patients with high IPI scores have only a few 5-year survivors, while those with low IPI scores have a 5-year survival rate of 50%. New Therapy Bio-immunotherapy Bio-therapeutic technology is an emerging anti-cancer method. The treatment method is to extract the blood of the patient, extract the immune cells and culture them in vitro, and then return to the patient after the culture, so that the immune cells can fight the cancer cells. Biotechnology combined with traditional therapy to improve the remission rate of mantle cell lymphoma and prolong the survival of patients. Autologous hematopoietic stem cell transplantation after high-dose myeloablative and post-chemotherapy should be used as a standard treatment for patients with mantle cell lymphoma, but recurrence after transplantation is the main The problem. If combined with biological immunotherapy, not only can enhance the patient's constitution, improve the quality of life, and clinical treatment shows that the complete response rate of patients in the biotherapy + rituximab group is significantly improved (33% vs 0%, P = 0.003), which One result clearly demonstrates the superiority of biological therapy for mantle cell lymphoma, and this increase in remission rate results in a significant improvement in patient survival.