据报道,三氧化二砷(ATO)调节淋巴瘤细胞周期,凋亡,自噬和线粒体活性,而它与其他细胞毒性剂协同作用。此外,ATO靶向间变性淋巴瘤激酶(ALK)-融合癌蛋白以抑制间变性大细胞淋巴瘤(ALCL)。本研究旨在探讨ATO联合依托泊苷的疗效和安全性,solumedrol,在复发或难治性(R/R)ALK+ALCL患者中,大剂量阿糖胞苷和顺铂(ESHAP)化疗与单纯ESHAP化疗相比。本研究共纳入24例R/RALK+ALCL患者。其中,11例患者接受ATO加ESHAP治疗,而其余13例患者仅接受ESHAP化疗。随后,治疗反应,无事件生存(EFS),记录总生存率(OS)和不良事件(AE)发生率.两者均完全反应(72.7%vs.53.8%;P=0.423)和客观反应(81.8%vs.与ESHAP组相比,ATO加ESHAP组的发生率为69.2%;P=0.649)。然而,没有达到统计学意义。此外,EFS显著延长(P=0.047),与ESHAP组相比,ATO加ESHAP组的OS没有显着增加(P=0.261)。更具体地说,ATO加ESHAP组的3年累积EFS和OS率分别为59.7%和77.1%,分别,在ESHAP组中,分别为13.8%和59.8%,分别。大多数AE,如血小板减少症(81.8%vs.46.2%;P=0.105),发烧(81.8%vs.46.2%;P=0.105)和呼吸困难(36.4%vs.15.4%;P=0.182),与ESHAP组相比,ATO加ESHAP组更为普遍。然而,没有观察到统计学意义。总之,目前的研究表明,在R/RALK+ALCL患者中,与单纯ESHAP化疗相比,ATO联合ESHAP化疗可发挥更好的疗效.
It has been reported that arsenic trioxide (ATO) regulates lymphoma cell cycle, apoptosis, autophagy and mitochondrial activity, while it synergizes with other cytotoxic agents. In addition, ATO targets anaplastic lymphoma kinase (ALK)-fusion oncoprotein to repress anaplastic large cell lymphoma (ALCL). The current study aimed to investigate the efficacy and safety of ATO plus etoposide, solumedrol, high-dose cytarabine and cisplatin (ESHAP) chemotherapy compared with ESHAP chemotherapy alone in patients with relapsed or refractory (R/R) ALK+ ALCL. A total of 24 patients with R/R ALK+ ALCL were enrolled in the present study. Among them, 11 patients were treated with ATO plus ESHAP, while the remaining 13 patients received ESHAP chemotherapy alone. Subsequently, treatment response, event-free survival (EFS), overall survival (OS) and adverse event (AEs) rates were recorded. Both complete response (72.7% vs. 53.8%; P=0.423) and objective response (81.8% vs. 69.2%; P=0.649) rates were higher in the ATO plus ESHAP group compared with the ESHAP group. However, statistical significance was not reached. In addition, EFS was significantly prolonged (P=0.047), while OS was not significantly increased (P=0.261) in the ATO plus ESHAP group compared with the ESHAP group. More specifically, the 3-year accumulating EFS and OS rates were 59.7 and 77.1% in the ATO plus ESHAP group, respectively, and 13.8 and 59.8% in the ESHAP group, respectively. The majority of AEs, such as thrombocytopenia (81.8% vs. 46.2%; P=0.105), fever (81.8% vs. 46.2%; P=0.105) and dyspnea (36.4% vs. 15.4%; P=0.182), were more prevalent in the ATO plus ESHAP group compared with the ESHAP group. However, no statistical significance was observed. In conclusion, the current study indicated that ATO plus ESHAP chemotherapy could exert a superior efficacy compared with ESHAP chemotherapy alone in patients with R/R ALK+ ALCL.