悪性リンパ腫に対する CHOP 療法,THP-COP 療法の有害事象と発熱性好中球減少症の危険因子解析
「緒言」悪性リンパ腫に対する標準治療はCHOP(cyclophosphamide:CPA, adriamycin:ADR, vincristine:VCR, prednisolone:PSL)療法であり1), さらにCD20陽性の場合にrituximabを併用したR-CHOP療法では, CHOP療法に対して全生存期間の有意な延長が認められている2). 一方, ADRの誘導体であるpirarubicin(tetrahydropyranyl adriamycin:THP)はADRに比較して総投与量の上限が高く, 心毒性の発現率も低い3)ことから, 主に高齢者を対象として, CHOP療法のADRをT...
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| Published in | 医療薬学 Vol. 36; no. 6; pp. 375 - 381 |
|---|---|
| Main Authors | , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人日本医療薬学会
2010
日本医療薬学会 |
| Online Access | Get full text |
| ISSN | 1346-342X 1882-1499 |
| DOI | 10.5649/jjphcs.36.375 |
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| Abstract | 「緒言」悪性リンパ腫に対する標準治療はCHOP(cyclophosphamide:CPA, adriamycin:ADR, vincristine:VCR, prednisolone:PSL)療法であり1), さらにCD20陽性の場合にrituximabを併用したR-CHOP療法では, CHOP療法に対して全生存期間の有意な延長が認められている2). 一方, ADRの誘導体であるpirarubicin(tetrahydropyranyl adriamycin:THP)はADRに比較して総投与量の上限が高く, 心毒性の発現率も低い3)ことから, 主に高齢者を対象として, CHOP療法のADRをTHPに変えたTHP-COP療法が行われている. THP-COP療法の有用性に関していくつかの報告4-8)がなされており, Kitamuraら9)は標準THP-COP療法に対してTHPとCPAの投与量を1.3倍とした70歳代の高用量THP-COP療法群で有意に完全寛解率が高かったとしている. |
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| AbstractList | 「緒言」悪性リンパ腫に対する標準治療はCHOP(cyclophosphamide:CPA, adriamycin:ADR, vincristine:VCR, prednisolone:PSL)療法であり1), さらにCD20陽性の場合にrituximabを併用したR-CHOP療法では, CHOP療法に対して全生存期間の有意な延長が認められている2). 一方, ADRの誘導体であるpirarubicin(tetrahydropyranyl adriamycin:THP)はADRに比較して総投与量の上限が高く, 心毒性の発現率も低い3)ことから, 主に高齢者を対象として, CHOP療法のADRをTHPに変えたTHP-COP療法が行われている. THP-COP療法の有用性に関していくつかの報告4-8)がなされており, Kitamuraら9)は標準THP-COP療法に対してTHPとCPAの投与量を1.3倍とした70歳代の高用量THP-COP療法群で有意に完全寛解率が高かったとしている. |
| Author | 小笠原, 信敬 岡田, 浩司 和野, 雅治 和賀, 信継 千代川, 千代吉 |
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| Copyright | 2010 日本医療薬学会 |
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| DOI | 10.5649/jjphcs.36.375 |
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| References | 1)R.I.Fisher,E.R.Gaynor,S.Dahlberg,M.M.Oken,T.M.Grogan,E.M.Mize,J.H.Glick,C.A.Coltman Jr,T.P.Miller,Comparison of a standard regimen (CHOP) with three intensive chemotherapy regimens for advanced nonHodgkin’s lymphoma,N.Engl.J.Med .,328,1002-1006 (1993). 17)G.H.Lyman,D.J.Delgado,Risk and timing of hospitalization for febrile neutropenia in patients receiving CHOP,CHOP-R,or CNOP chemotherapy for intermediate-grade non-Hodgkin lymphoma,Cancer ,98,2402-2409 (2003). 4)K.Kitamura,F.Takaku,Pirarubicin,a novel derivative of doxorubicin,THP-COP therapy for non-Hodgkin’s lymphoma in the elderly,Am.J.Clin.Oncol .,13,Suppl 1,S 15-19 (1990). 5)S.Aoki,N.Tsukada,N.Nomoto,S.Maruyama,M.Takahashi,Y.Moriyama,A.Shibata,Y.Aizawa,Effect of pirarubicin for elderly patients with malignant lymphoma,J.Exp.Clin.Cancer.Res .,17,465-470 (1998). 15)アドリアシン注用10添付文書,協和発酵キリン株式会社,2009年10月改訂. 6)H.Tsurumi,T.Hara,N.Goto,N.Kanemura,S.Kasahara,M.Sawada,I.Yasuda,T.Yamada,M.Shimizu,T.Takami,H.Moriwaki,A phase II study of a THP-COP regimen for the treatment of elderly patients aged 70 years or older with diffuse large B-cell lymphoma,Hematol.Oncol .,25,107-114 (2007). 18)辻井悟,糖尿病·高脂血症への対策,臨床研修プラクティス,5,88-93 (2008). 19)長坂昌一郎,高血糖を誘発する薬剤への対処,内科,101,92-95 (2008). 2)B.Coiffier,E.Lepage,J.Briere,R.Herbrecht,H.Tilly,R.Bouabdallah,P.Morel,E.Van Den Neste,G Salles,P.Gaulard,F.Reyes,P.Lederlin,C.Gisselbrecht,CHOP chemotherapy plus rituximab compared with CHOP alone in elderly patients with diffuse large-B-cell lymphoma,N.Engl.J.Med .,346,235-242 (2002). 3)ピノルビン 注射用添付文書,日本化薬株式会社,2009 年 10 月改訂. 13)中尾俊也,木村美智男,宇佐美英績,岡田和智,岩井美奈,“がん必須ポイント”,吉村知哲編,じほう,東京,2007,pp.99-107. 11)M.Mori,K.Kitamura,M.Masuda,T.Hotta,T.Miyazaki,A.B.Miura,H.Mizoguchi,A.Shibata,H.Saito,T.Matsuda,T.Masaoka,M.Harada,Y.Niho,F.Takaku,Longterm results of a multicenter randomized,comparative trial of modified CHOP versus THP-COP versus THP-COPE regimens in elderly patients with non-Hodgkin’s lymphoma,Int.J.Hematol .,81,246-254 (2005). 14)岡本るみ子,佐々木常雄,“新臨床腫瘍学”,日本臨床腫瘍学会編,南江堂,東京,2006,pp.716-723. 8)北村聖,高齢者悪性リンパ腫の治療方針,日本内科学会雑誌,90,1010-1018 (2001). 10)H.Tsurumi,T.Yamada,M.Sawada,S.Kasahara,N.Kanemura,Y.Kojima,K.Fukuno,T.Hara,M.Saio,T.Takahashi,M.Oyama,K.Ozawa,T.Takami,H.Moriwaki,Biweekly CHOP or THP-COP regimens in the treatment of newly diagnosed aggressive non-Hodgkin’s lymphoma,A comparison of doxorubicin and pirarubicin,a randomized phase II study,J.Cancer.Res.Clin.Oncol .,130,107-113 (2004). 9)K.Kitamura,M.Mori,M.Masuda,T.Hotta,T.Miyazaki,R.Miura,H.Mizoguti,A.Shibata,H.Saitoh,T.Matuda,T.Masaoka,M.Harada,Y.Niho,F.Takaku,Comparison of high and low doses of T-COP regimens including a new anthracyclin pirarubicin (THP),in elderly patients with nonHodgkin’s lymphoma,Blood ,92(10,Supple 1)(1998). 12)M.Kikukawa,K.Miyazaki,A.Kiuchi,S.Abe,H.Fujii,K.Kanaya,K.Shin,T.Iwamoto,The efficacy and adverse effects of rituximab with CHOP or THP-COP in old-old and extremely old patients with diffuse large B cell lymphoma,Nippon Ronen Igakkai Zasshi ,43,236-240 (2006). 7)T.Hara,H.Tsurumi,N.Goto,J.Kitagawa,N.Kanemura,T.Yoshikawa,S.Kasahara,H.Goto,K.Fukuno,T.Yamada,M.Sawada,I.Yasuda,N.Katsumura,T.Takahashi,T.Takami,H.Moriwaki,Phase II study of Rituximab combined with THP-COP as first-line therapy for patients younger than 70 years with diffuse large B cell lymphoma,J.Cancer.Res.Clin.Oncol .,136,65-70 (2010). 16)田村和夫,末梢神経障害,Mebio Oncology ,2,51-58 (2005). |
| References_xml | – reference: 7)T.Hara,H.Tsurumi,N.Goto,J.Kitagawa,N.Kanemura,T.Yoshikawa,S.Kasahara,H.Goto,K.Fukuno,T.Yamada,M.Sawada,I.Yasuda,N.Katsumura,T.Takahashi,T.Takami,H.Moriwaki,Phase II study of Rituximab combined with THP-COP as first-line therapy for patients younger than 70 years with diffuse large B cell lymphoma,J.Cancer.Res.Clin.Oncol .,136,65-70 (2010). – reference: 4)K.Kitamura,F.Takaku,Pirarubicin,a novel derivative of doxorubicin,THP-COP therapy for non-Hodgkin’s lymphoma in the elderly,Am.J.Clin.Oncol .,13,Suppl 1,S 15-19 (1990). – reference: 11)M.Mori,K.Kitamura,M.Masuda,T.Hotta,T.Miyazaki,A.B.Miura,H.Mizoguchi,A.Shibata,H.Saito,T.Matsuda,T.Masaoka,M.Harada,Y.Niho,F.Takaku,Longterm results of a multicenter randomized,comparative trial of modified CHOP versus THP-COP versus THP-COPE regimens in elderly patients with non-Hodgkin’s lymphoma,Int.J.Hematol .,81,246-254 (2005). – reference: 1)R.I.Fisher,E.R.Gaynor,S.Dahlberg,M.M.Oken,T.M.Grogan,E.M.Mize,J.H.Glick,C.A.Coltman Jr,T.P.Miller,Comparison of a standard regimen (CHOP) with three intensive chemotherapy regimens for advanced nonHodgkin’s lymphoma,N.Engl.J.Med .,328,1002-1006 (1993). – reference: 17)G.H.Lyman,D.J.Delgado,Risk and timing of hospitalization for febrile neutropenia in patients receiving CHOP,CHOP-R,or CNOP chemotherapy for intermediate-grade non-Hodgkin lymphoma,Cancer ,98,2402-2409 (2003). – reference: 5)S.Aoki,N.Tsukada,N.Nomoto,S.Maruyama,M.Takahashi,Y.Moriyama,A.Shibata,Y.Aizawa,Effect of pirarubicin for elderly patients with malignant lymphoma,J.Exp.Clin.Cancer.Res .,17,465-470 (1998). – reference: 8)北村聖,高齢者悪性リンパ腫の治療方針,日本内科学会雑誌,90,1010-1018 (2001). – reference: 6)H.Tsurumi,T.Hara,N.Goto,N.Kanemura,S.Kasahara,M.Sawada,I.Yasuda,T.Yamada,M.Shimizu,T.Takami,H.Moriwaki,A phase II study of a THP-COP regimen for the treatment of elderly patients aged 70 years or older with diffuse large B-cell lymphoma,Hematol.Oncol .,25,107-114 (2007). – reference: 14)岡本るみ子,佐々木常雄,“新臨床腫瘍学”,日本臨床腫瘍学会編,南江堂,東京,2006,pp.716-723. – reference: 3)ピノルビン 注射用添付文書,日本化薬株式会社,2009 年 10 月改訂. – reference: 2)B.Coiffier,E.Lepage,J.Briere,R.Herbrecht,H.Tilly,R.Bouabdallah,P.Morel,E.Van Den Neste,G Salles,P.Gaulard,F.Reyes,P.Lederlin,C.Gisselbrecht,CHOP chemotherapy plus rituximab compared with CHOP alone in elderly patients with diffuse large-B-cell lymphoma,N.Engl.J.Med .,346,235-242 (2002). – reference: 12)M.Kikukawa,K.Miyazaki,A.Kiuchi,S.Abe,H.Fujii,K.Kanaya,K.Shin,T.Iwamoto,The efficacy and adverse effects of rituximab with CHOP or THP-COP in old-old and extremely old patients with diffuse large B cell lymphoma,Nippon Ronen Igakkai Zasshi ,43,236-240 (2006). – reference: 9)K.Kitamura,M.Mori,M.Masuda,T.Hotta,T.Miyazaki,R.Miura,H.Mizoguti,A.Shibata,H.Saitoh,T.Matuda,T.Masaoka,M.Harada,Y.Niho,F.Takaku,Comparison of high and low doses of T-COP regimens including a new anthracyclin pirarubicin (THP),in elderly patients with nonHodgkin’s lymphoma,Blood ,92(10,Supple 1)(1998). – reference: 18)辻井悟,糖尿病·高脂血症への対策,臨床研修プラクティス,5,88-93 (2008). – reference: 16)田村和夫,末梢神経障害,Mebio Oncology ,2,51-58 (2005). – reference: 15)アドリアシン注用10添付文書,協和発酵キリン株式会社,2009年10月改訂. – reference: 13)中尾俊也,木村美智男,宇佐美英績,岡田和智,岩井美奈,“がん必須ポイント”,吉村知哲編,じほう,東京,2007,pp.99-107. – reference: 10)H.Tsurumi,T.Yamada,M.Sawada,S.Kasahara,N.Kanemura,Y.Kojima,K.Fukuno,T.Hara,M.Saio,T.Takahashi,M.Oyama,K.Ozawa,T.Takami,H.Moriwaki,Biweekly CHOP or THP-COP regimens in the treatment of newly diagnosed aggressive non-Hodgkin’s lymphoma,A comparison of doxorubicin and pirarubicin,a randomized phase II study,J.Cancer.Res.Clin.Oncol .,130,107-113 (2004). – reference: 19)長坂昌一郎,高血糖を誘発する薬剤への対処,内科,101,92-95 (2008). |
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| Snippet | 「緒言」悪性リンパ腫に対する標準治療はCHOP(cyclophosphamide:CPA, adriamycin:ADR, vincristine:VCR, prednisolone:PSL)療法であり1), さらにCD20陽性の場合にrituximabを併用したR-CHOP療法では,... |
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| Title | 悪性リンパ腫に対する CHOP 療法,THP-COP 療法の有害事象と発熱性好中球減少症の危険因子解析 |
| URI | https://www.jstage.jst.go.jp/article/jjphcs/36/6/36_6_375/_article/-char/ja http://mol.medicalonline.jp/en/journal/download?GoodsID=db5pharm/2010/003606/002&name=0375-0381j |
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