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Fakultas Kedokteran / Departemen Ilmu Penyakit Dalam
Tim Peneliti :
- Ami Ashariati --> Peneliti Utama
Tahun : 2010
Halaman Naskah : 0 halaman
Sumber Dana : Mandiri
Besaran Dana : 0
SK. Penetapan : Mandiri
Publikasi : Buku : HOM Update IX 2010
Kategori Penelitian : Kesehatan
Posting : 20-02-2012
Visitor : 7718
DLBCL: Diagnosis and Optimizing Rituximab-based therapy to cure patient
Author : Dr. Ami Ashariati, dr., Sp.PD, K-HOM
Year : 2010
Ami Ashariati, dr., SpPD.,KHOM
Division of Hematology - Medical Oncology
Department of Internal Medicine
Faculty of Medicine Airlangga University – Dr.Soetomo Hospital
The global incidence of Non-Hodgkins Lymphoma (NHL) has been rising continually for some years, and NHL is now the fifth most common cancer in the United States. In Indonesia have not data exactly. Indolent NHL remains largely in incurable disease, with nearly static overall survival. Only 30-40% of patients with aggressive NHL are cured by the standard regimen of CHOP (cyclophosphamide /doxorubicin/ vincristine/ prednisone) chemotherapy. More intensive regimens may benefit a subset of NHL patients , but at the cost of higher toxicity.
Diffuse large B-cell non-Hodgkins lymphoma (DLBCL) constitutes 30%–58% of non-Hodgkins lymphoma series. The crude incidence in the European Union is 3–4/100 000/year. The incidence increases with age from 0.3/100 000/year (35–39 years) to 26.6/100 000/year (80–84 years).
Diagnosis of NHL should be made on the basis of a surgical specimen/ excisional lymph node or extranodal tissue biopsy providing enough material for formalin-ﬁxed samples. Core biopsies may be appropriate as the only diagnostic test in the rare patients requiring emergency treatment. Minimal immunohistochemistry (CD45, CD20 and CD3) is mandatory.
Today, the principal treatment for NHL is combination chemotherapy and radiation therapy. Surgery is used chiefly as a diagnostic tool, with some unique exceptions. Combination chemotherapy with cyclophosphamide, doxorubicin, vincristine, and prednisone-the CHOP regimen-was developed at M.D. Anderson Cancer Center and introduced in the 1970s. Since then, a number of second- and third-generation regimens and combinations of non-cross-resistant regimens for intermediate- and high-grade NHLs have been developed. The benefit of these newer regimens is now in question, but some issues are not yet clearly resolved.
Current trials of chemotherapy for NHL may hold the answers. The emergence of newer biologic therapies in recent years has expanded the rang of treatment options in oncology. Rituximab is the chimeric human/mouse monoclonal antibody , it targets the CD20 antigen, present on malignant cells of the B-cell lineage, but not on primitive stem cells or mature plasma cells. Importantly, the new biologic therapies relatively very expensive, espesially for most common NHL patients. The addition of rituximab to the cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP) regimen has greatly improved outcomes for patients with diffuse large B-cell lymphoma (DLBCL), the most frequently-occurring subtype of non-Hodgkins lymphomas. CD20 as Ideal Target for patients with diffuse large B-cell lymphoma (DLBCL).
Keyword : DLBCL, Diagnosis and Optimizing, Rituximab-based therapy,
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