胃と腸49巻5号

2014年05月発行

増刊号 消化管悪性リンパ腫2014

主題 消化管原発aggressive lymphoma―diffuse large B-cell lymphoma

胃DLBCLの診断と治療―臨床試験に基づく治療

著者： 加藤知爾¹ 矢野友規¹ 桑田健² 塚崎邦弘³

所属機関： ¹国立がん研究センター東病院消化管内視鏡科 ²国立がん研究センター東病院病理・臨床検査科 ³国立がん研究センター東病院血液腫瘍科

ページ範囲：P.720 - P.728

文献概要

びまん性大細胞型B細胞リンパ腫（diffuse large B-cell lymphoma ; DLBCL）は非Hodgkinリンパ腫の約30～40％を占め，本邦で最多の悪性リンパ腫である．約3割のDLBCLは節外性リンパ腫と呼ばれ，胃は好発部位である．胃原発DLBCLの臨床試験に基づく標準治療は，限局期〔Lugano国際会議分類Stage I，II1期（巨大腫瘤性病変を含まない）〕ではR-CHOP6-8コースかR-CHOP3コース＋IFRTである．進行期〔Lugano国際会議分類Stage II2期以上（巨大腫瘤性病変を含む）〕ではR-CHOP6-8コースである．再発，再燃DLBCLには，救済療法が奏効すれば自家造血幹細胞移植併用の大量化学療法が標準治療である．初回治療不応，再発の場合，エビデンスのある治療法はなく，さまざまな救援化学療法と新薬開発が行われている．

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