{"id":115,"date":"2008-06-19T17:27:52","date_gmt":"2008-06-19T08:27:52","guid":{"rendered":"http:\/\/haruko.km2m.net\/2008\/06\/19\/%e9%80%a0%e8%a1%80%e5%b9%b9%e7%b4%b0%e8%83%9e%e7%a7%bb%e6%a4%8d%e3%81%ae%e9%81%a9%e5%bf%9c%e3%82%ac%e3%82%a4%e3%83%89%e3%83%a9%e3%82%a4%e3%83%b3\/"},"modified":"2008-06-19T17:27:52","modified_gmt":"2008-06-19T08:27:52","slug":"%e9%80%a0%e8%a1%80%e5%b9%b9%e7%b4%b0%e8%83%9e%e7%a7%bb%e6%a4%8d%e3%81%ae%e9%81%a9%e5%bf%9c%e3%82%ac%e3%82%a4%e3%83%89%e3%83%a9%e3%82%a4%e3%83%b3","status":"publish","type":"post","link":"https:\/\/haruko.km2m.net\/?p=115","title":{"rendered":"\u9020\u8840\u5e79\u7d30\u80de\u79fb\u690d\u306e\u9069\u5fdc\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3"},"content":{"rendered":"

\u9020\u8840\u5e79\u7d30\u80de\u79fb\u690d\u306e\u9069\u5fdc\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3 2002\u5e744\u6708<\/p>\n

\n\uff11\uff0e \u308d\u80de\u6027\u30ea\u30f3\u30d1\u816b \u81e8\u5e8a\u6210\u7e3e<\/p>\n

\uff11\uff09 \u5316\u5b66\u7642\u6cd5\u306e\u6210\u7e3e
\n\u3000\u6ffe\u80de\u6027\u30ea\u30f3\u30d1\u816b\u306e\u7d0410\uff5e15%\u304c\u2160\u671f\u304a\u3088\u3073non-bulky \u2161\u671f\u306e\u9650\u5c40\u671f\u75c7\u4f8b\u3067\u3042\u308a\u3001\u653e\u5c04\u7dda\u7167\u5c04\u306b\u3088\u308b\u5c40\u6240\u5236\u5fa1\u306710\u5e74\u306efailure-free survival\u306f50\uff5e60%\u3001\u307e\u305f\u5168\u751f\u5b58\u7387\u306f60\uff5e80%\u3068\u9577\u671f\u9593\u306e\u75be\u60a3\u5236\u5fa1\u304c\u53ef\u80fd\u3067\u3042\u308b\u304c10%\u4ee5\u4e0a\u306e\u75c7\u4f8b\u306f10\u5e74\u306e\u5bdb\u89e3\u5f8c\u3082\u518d\u767a\u3057\u3001\u9650\u5c40\u671f\u3068\u3044\u3048\u3069\u3082\u6cbb\u7652\u306f\u56f0\u96e3\u3067\u3042\u308b5)\u3002<\/p>\n

\u3057\u304b\u3057\u300110\u5e74\u751f\u5b58\u7387\u304c50%\u4ee5\u4e0a\u3067\u3042\u308b\u3053\u3068\u304b\u3089\u3001\u9650\u5c40\u671f\uff08\u65e9\u671f\uff09\u75c7\u4f8b\u306b\u5bfe\u3059\u308b\u9020\u8840\u5e79\u7d30\u80de\u79fb\u690d\u306e\u9069\u5fdc\u306f\u306a\u3044\u3002\u4e00\u65b9\u3001Bulky \u2161\u671f\u3001\u2162\u671f\u3001\u2163\u671f\u306e\u9032\u884c\u671f\u75c7\u4f8b\u3067\u306f\u5316\u5b66\u7642\u6cd5\u3067\u816b\u760d\u306e\u7e2e\u5c0f\u52b9\u679c\u304c\u5f97\u3089\u308c\u308b\u3082\u306e\u306e\u3001\u5316\u5b66\u7642\u6cd5\u306f\u751f\u5b58\u306e\u5ef6\u9577\u306b\u306f\u5bc4\u4e0e\u305b\u305a\u3001\u3055\u3089\u306b\u3001\u4f75\u7528\u3059\u308b\u85ac\u5264\u3092\u3088\u308a\u5f37\u529b\u306a\u3082\u306e\u306b\u3057\u3066\u3082\u751f\u5b58\u5ef6\u9577\u306b\u306f\u5bc4\u4e0e\u3057\u306a\u3044\u3053\u3068\u304c\u660e\u3089\u304b\u3068\u306a\u3063\u3066\u3044\u308b6-8)\u3002<\/p>\n

\u5f8c\u8a18\u3059\u308b\u3088\u3046\u306b\u6700\u8fd1CD20\u6297\u4f53\u304c\u958b\u767a\u3055\u308c\u3001\u3068\u304f\u306b\u6297\u304c\u3093\u5264\u3068\u306e\u4f75\u7528\u306b\u3088\u308aminimal residual disease\uff08MRD\uff09\u304c\u6d88\u5931\u3059\u308b\u75c7\u4f8b\u3082\u8a8d\u3081\u3089\u308c\u308b\u3053\u3068\u304b\u3089\u3001\u4eca\u5f8cCD20\u6297\u4f53\u3092\u542b\u3081\u305f\u5316\u5b66\u7642\u6cd5\u306e\u52b9\u679c\u3092\u898b\u6975\u3081\u305f\u4e0a\u3067\u79fb\u690d\u306e\u9069\u5fdc\u3092\u6c7a\u3081\u308b\u5fc5\u8981\u304c\u3042\u308d\u3046\u3002<\/p>\n

\n\uff12\uff09 \u81ea\u5bb6\u9020\u8840\u5e79\u7d30\u80de\u79fb\u690d\u306e\u6210\u7e3e
\n\u3000\u3053\u306e\u6cbb\u7642\u6cd5\u306b\u3088\u308a\u5bdb\u89e3\u671f\u9593\u306e\u5ef6\u9577\u306f\u8a8d\u3081\u3089\u308c\u308b\u3082\u306e\u306e\u751f\u5b58\u66f2\u7dda\u306fplateau\u306b\u306a\u3089\u305a\u30011997\u5e74\u306eBierman\u3089\u306e100\u4f8b\u306e\u89e3\u6790\u3067\u3082\uff14\u5e74\u5168\u751f\u5b58\u7387\u306f65%\u3067\u3042\u3063\u305f\u304c\uff14\u5e74\u306efailure free survival\u306f44%\u3067\u751f\u5b58\u66f2\u7dda\u3082\u53f3\u80a9\u4e0b\u304c\u308a\u3067plateau\u306b\u306a\u3089\u305a\u3001\u540c\u69d8\u306a\u6210\u7e3e\u306fFreedman\u3089\u306b\u3088\u3063\u3066\u3082\u5831\u544a\u3055\u308c\u3001\u3059\u306a\u308f\u3061\u672b\u68a2\u8840\u30fb\u9aa8\u9ac4\u6d78\u6f64\u304c\u304d\u308f\u3081\u3066\u983b\u7e41\u306b\u8a8d\u3081\u3089\u308c\u308b\u308d\u80de\u6027\u30ea\u30f3\u30d1\u816b\u306b\u5bfe\u3059\u308bpurging\u3092\u3057\u306a\u3044\u901a\u5e38\u306e\u81ea\u5bb6\u79fb\u690d\u3067\u306f\u6cbb\u7652\u304c\u671f\u5f85\u3067\u304d\u308b\u6cbb\u7642\u6cd5\u3068\u3057\u3066\u78ba\u7acb\u3057\u3066\u3044\u306a\u3044\u3053\u3068\u304c\u793a\u3055\u308c\u305f9,10)\u3002<\/p>\n

\n\u3000\u81e8\u5e8a\u7814\u7a76\u306e\u6bb5\u968e\u3067\u306f\u3042\u308b\u304c\u3001\u6ffe\u80de\u6027\u30ea\u30f3\u30d1\u816b\u306b\u6cbb\u7652\u304c\u671f\u5f85\u3067\u304d\u308b\u6cbb\u7642\u6cd5\u3068\u3057\u3066\u306f\u81ea\u5bb6\u9020\u8840\u5e79\u7d30\u80de\u79fb\u690d\u4f75\u7528\u3067\u306f\u3001Dana Farber Cancer Institute\u306b\u304a\u3051\u308b\u6297B\u7d30\u80de\u6297\u4f53\u3068\u88dc\u4f53\u3092\u7528\u3044\u305fex vivo purg-ing\u51e6\u7406\u3092\u3057\u305f\u81ea\u5bb6\u9aa8\u9ac4\u79fb\u690d\u3092\u4f75\u7528\u3057\u305f\u5927\u91cf\u5316\u5b66\u653e\u5c04\u7dda\u7642\u6cd5\u304c\u3042\u308b\u30021991\u5e74\u306bGribben\u3089\u304c\u5831\u544a\u3057\u305f\u6642\u70b9\u3067\u672a\u51e6\u7406\u306e\uff08PCR\u65b9\u3067\u5fae\u5c11\u6b8b\u5b58\u816b\u760d\u304c\u967d\u6027\u306e\uff09\u7fa4\u306b\u6bd4\u3057\u3066ex vivo purging\u51e6\u7406\u51e6\u7406\u7fa4\uff08PCR\u6cd5\u3067\u9670\u6027\u7fa4\uff09 \u306e\u751f\u5b58\u7387\u306e\u512a\u4f4d\u6027\u304c\u8a8d\u3081\u3089\u308c\u305f\u304c11)
\n\u30011999\u5e74\u306bFreedman\u3089\u306b\u3088\u308a\u5831\u544a\u3055\u308c\u305fup-date\u306e\u5831\u544a\u3067\u306fex vivo purging\u51e6\u7406\u7fa4\u306e\uff18\u5e74\u751f\u5b58\u7387\u306f83%\u3067\u307b\u307cplateau\u306b\u306a\u3063\u3066\u304a\u308a\u3001\u81ea\u5bb6\u9020\u8840\u5e79\u7d30\u80de\u79fb\u690d\u7247\u4e2d\u306e\u30ea\u30f3\u30d1\u816b\u7d30\u80de\u3092\u30d1\u30fc\u30b8\u30f3\u30b0\u306b\u3088\u308aPCR\u65b9\u30ec\u30d9\u30eb\u3067\u9670\u6027\u5316\u3059\u308c\u3070\u81ea\u5bb6\u9020\u8840\u5e79\u7d30\u80de\u79fb\u690d\u4f75\u7528\u306e\u5927\u91cf\u5316\u5b66\u653e\u5c04\u7dda\u7642\u6cd5\u3067\u6cbb\u7652\u304c\u671f\u5f85\u3067\u304d\u308b\u3053\u3068\u3092\u793a\u3057\u3066\u3044\u308b12)\u3002<\/p>\n

\n\u3000\u4e00\u65b9\u3001\u9032\u884c\u518d\u767a\u75c7\u4f8b\u306f\u3001\u521d\u767a\u4f8b\u306b\u6bd4\u3079\u4e88\u5f8c\u304c\u4e0d\u826f\uff08\u6570\u5e74\u4ee5\u4e0b\uff09\u3068\u306a\u308b\u305f\u3081\u3001\u30d1\u30fc\u30b8\u30f3\u30b0\u306b\u3088\u308b\u81ea\u5bb6\u9020\u8840\u5e79\u7d30\u80de\u79fb\u690d\u3068\u540c\u7a2e\u79fb\u690d\u306f\u7814\u7a76\u7684\u6cbb\u7642\u6cd5\u3068\u3057\u3066\u59a5\u5f53\u3067\u3042\u308b\u3002<\/p>\n

\uff13\uff09 \u30ad\u30e1\u30e9\u578b\u6297CD20\u6297\u4f53\uff08rituximab\u3001 \u30ea\u30c4\u30ad\u30b5\u30f3\uff09\u306e\u6210\u7e3e
\n\u3000\u7c73\u56fd\u306b\u304a\u3044\u3066\u958b\u767a\u3055\u308c\u305f\u30ad\u30e1\u30e9\u578b\u6297CD20\u6297\u4f53\uff08Rituximab\uff1a\u30ea\u30c4\u30ad\u30b5\u30f3\uff09\u306e\u518d\u767a\u307e\u305f\u306f\u6cbb\u7642\u62b5\u6297\u6027\u306e\u4e3b\u306b\u4f4e\u60aa\u6027\u5ea6\u30ea\u30f3\u30d1\u816b\u3092\u5bfe\u8c61\u3068\u3057\u305f\u81e8\u5e8a\u8a66\u9a13\u306e\u7d50\u679c\u3001\u5358\u72ec\uff14\u56de\u6295\u4e0e\u306b\u304a\u3051\u308b\u6297\u816b\u760d\u52b9\u679c\u306f151\u4f8b\u4e2d\u594f\u52b9\u4f8b\u304c76\u4f8b\uff08CR\uff19\u4f8b\uff0bPR67\u4f8b\uff09\u3068\u9ad8\u7387\u306a\u594f\u52b9\u7387\u304c\u5f97\u3089\u308c\u3001time to progression\u306e\u4e2d\u592e\u5024\u306f12.5\u30f6\u6708\u3067\u3042\u3063\u305f\u3002\u85ac\u7269\u6709\u5bb3\u53cd\u5fdc\u3068\u3057\u3066\u306f\u3001\u307b\u3068\u3093\u3069\u304c\u8efd\u5ea6\u306a\u3082\u306e\uff08grade 2\u4ee5\u4e0b\uff09\u3067\u3001\u4f55\u308c\u308224\u6642\u9593\u4ee5\u5185\u306b\u6d88\u5931\u3057\u305f\u3002\u307e\u305f\u3001\u975e\u8840\u6db2\u6bd2\u6027\u306f\u7b2c1\u56de\u76ee\u306e\u6295\u4e0e\u6642\u306b\u6bd4\u3079\u3001\uff12\uff5e\uff14\u56de\u76ee\u306e\u6295\u4e0e\u6642\u306b\u306f\u6e1b\u5c11\u3057\u305f\u3002<\/p>\n

\u672b\u68a2\u8840\u4e2d\u306e\u816b\u760d\u7d30\u80de\u6570\u304c\uff15\u4e07\/ml\u4ee5\u4e0a\u306a\u3069\u306e\u816b\u760d\u91cf\u304c\u591a\u3044\u75c7\u4f8b\u3067\u306f\u521d\u56de\u6295\u4e0e\u6642\u306bTNF a\u3084IL-6\u306e\u653e\u51fa\u306b\u4f34\u3046\u60aa\u5bd2\u767a\u71b1\u3001\u60aa\u5fc3\u5614\u5410\u3001\u8840\u5727\u4f4e\u4e0b\u3001\u547c\u5438\u56f0\u96e3\u306a\u3069\u306ecytokine-release syndrome\u304c\u8d77\u304d\u308b\u3053\u3068\u304c\u5831\u544a\u3055\u308c\u3066\u304a\u308a\u3001\u6ce8\u610f\u304c\u5fc5\u8981\u3067\u3042\u308b14)\u3002<\/p>\n

\n\u3000\u65e5\u672c\u306b\u304a\u3051\u308b\u7b2c\u2161\u76f8\u8a66\u9a13\u306e\u7d50\u679c\u3067\u3082\u3001indolent\u30ea\u30f3\u30d1\u816b\uff08\u6ffe\u80de\u6027\u306a\u3069\uff0934\u4f8b\u4e2d21\u4f8b\u304c\u6709\u52b9\uff08CR\uff14\u4f8b\u3001PR17\u4f8b\uff09\u3067\u594f\u52b9\u7387\u306f60.0%\u3068\u9ad8\u7387\u3067\u3042\u308a\u3001\u6709\u5bb3\u4e8b\u8c61\u3082\u7c73\u56fd\u3067\u306e\u8a66\u9a13\u540c\u69d8\u306b\u8efd\u5fae\u306a\u3082\u306e\u3067\u3042\u3063\u305f\u3002<\/p>\n

\n\u3000\u672a\u6cbb\u7642\u75c7\u4f8b\u3092\u5bfe\u8c61\u306b\u3057\u3066Rituximab\u5358\u5264\u306e\uff14\u56de\u53cd\u5fa9\u6295\u4e0e\u306e\u81e8\u5e8a\u7b2c\u2161\u76f8\u8a66\u9a13\u304c\u7c73\u56fd\u3068\u30d5\u30e9\u30f3\u30b9\u3067\u5b9f\u65bd\u3055\u308c\u3001\u305d\u308c\u305e\u308c64%\u300169%\u3068\u9ad8\u3044\u594f\u52b9\u7387\u304c\u5831\u544a\u3055\u308c\u3066\u3044\u308b15)\u3002<\/p>\n

\u3000\u6297CD20\u6297\u4f53\u306f\u305d\u306e\u4f5c\u7528\u6a5f\u5e8f\u304c\u6297\u304c\u3093\u5264\u3068\u307e\u3063\u305f\u304f\u7570\u306a\u308b\u305f\u3081\u306b\u3001\u6297\u304c\u3093\u5264\u3068\u306e\u4f75\u7528\u3067\u6297\u816b\u760d\u52b9\u679c\u304c\u9ad8\u307e\u308b\u3053\u3068\u304c\u671f\u5f85\u3055\u308c\u308b\u3002\u305d\u3053\u3067\u3001\u975e\u30db\u30b8\u30ad\u30f3\u30ea\u30f3\u30d1\u816b\u306b\u5bfe\u3059\u308b\u6a19\u6e96\u7684\u6cbb\u7642\u6cd5\u3067\u3042\u308bCHOP\u7642\u6cd5\uff16\u30b5\u30a4\u30af\u30eb\u3068rituximab 375mg\/m2 6\u56de\u6295\u4e0e\u3068\u306e\u4f75\u7528\u304c\u3001\u4f4e\u60aa\u6027\u5ea6\u975e\u30db\u30b8\u30ad\u30f3\u30ea\u30f3\u30d1\u816b\uff08\u6ffe\u80de\u6027B\u7d30\u80de\u30ea\u30f3\u30d1\u816b\u3092\u542b\u3080\uff09 38\u4f8b\u3092\u5bfe\u8c61\u306b\u5b9f\u65bd\u3055\u308c\u305f16)\u3002\u305d\u306e\u7d50\u679c\u3001\u594f\u52b9\u7387100% \uff08intention to treat analysis\u3067\u306f97%\uff09\u3067\u3001\u8ffd\u8de1\u671f\u959329\u30f6\u6708\uff08\u4e2d\u592e\u5024\uff09\u306738\u4f8b\u4e2d28\u4f8b\u304c\u5bdb\u89e3\u3092\u7dad\u6301\u3057\u3066\u3044\u308b\u306a\u3069\u304d\u308f\u3081\u3066\u512a\u308c\u305f\u6297\u816b\u760d\u52b9\u679c\u304c\u8a8d\u3081\u3089\u308c\u3001\u307e\u305f\u3001\u4f75\u7528\u306b\u3088\u308a\u4e21\u85ac\u5264\u306e\u6709\u5bb3\u4e8b\u8c61\u304c\u5897\u5f37\u3059\u308b\u50be\u5411\u306f\u306a\u304b\u3063\u305f\u3002<\/p>\n

\u7279\u7b46\u3059\u3079\u304d\u306f\u3053\u306e\u4f75\u7528\u7642\u6cd5\u306b\u3088\u308aPCR\u6cd5\u306b\u3088\u308b\u5fae\u5c11\u6b8b\u5b58\u816b\u760d\u7d30\u80de\uff08mininal residual disease: MRD\uff09\u306e\u6d88\u5931\u3057\u305f\u75c7\u4f8b\u304c\u3042\u308a\u3001\u5f93\u6765\u306e\u5316\u5b66\u7642\u6cd5\u3067\u306f\u6cbb\u7652\u304c\u671b\u307f\u306b\u304f\u3044\u3053\u306e\u75c5\u578b\u306b\u304a\u3044\u3066\u6cbb\u7652\u306e\u53ef\u80fd\u6027\u304c\u3067\u3066\u304d\u305f\u3053\u3068\u3067\u3042\u308b\u3002<\/p>\n

\u3000\u4f4e\u60aa\u6027\u5ea6\u30fb\u6ffe\u80de\u6027\u30ea\u30f3\u30d1\u816b\u75c7\u4f8b\u306b\u304a\u3044\u3066Rituximab\u6295\u4e0e\u5f8c\u306e\u518d\u767a\u6642\u306b\u518d\u6295\u4e0e\u3057\u3066\u3082\u594f\u52b9\u738740%\uff08CR11%\u3001PR30%\uff09 \u3068\u6709\u52b9\u6027\u304c\u3042\u308a\u3001\u91cd\u7be4\u306a\u6709\u5bb3\u4e8b\u8c61\u306e\u51fa\u73fe\u3059\u308b\u3053\u3068\u306f\u7a00\u3067\u3042\u308b\u3068\u5831\u544a\u3055\u308c\u3066\u3044\u308b17)<\/p>\n

\u3002<\/p>\n","protected":false},"excerpt":{"rendered":"

\u9020\u8840\u5e79\u7d30\u80de\u79fb\u690d\u306e\u9069\u5fdc\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3 2002\u5e744\u6708 \uff11\uff0e \u308d\u80de\u6027\u30ea\u30f3\u30d1\u816b \u81e8\u5e8a\u6210\u7e3e \uff11\uff09 \u5316\u5b66\u7642\u6cd5\u306e\u6210\u7e3e \u3000\u6ffe\u80de\u6027\u30ea\u30f3\u30d1\u816b\u306e\u7d0410\uff5e15%\u304c\u2160\u671f\u304a\u3088\u3073non-bulky \u2161\u671f\u306e\u9650\u5c40\u671f\u75c7\u4f8b\u3067\u3042\u308a\u3001\u653e\u5c04\u7dda\u7167\u5c04\u306b\u3088\u308b\u5c40\u6240\u5236\u5fa1\u30671 … <\/p>\n

“\u9020\u8840\u5e79\u7d30\u80de\u79fb\u690d\u306e\u9069\u5fdc\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3” \u306e<\/span>\u7d9a\u304d\u3092\u8aad\u3080<\/a><\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4],"tags":[],"class_list":["post-115","post","type-post","status-publish","format-standard","hentry","category-4"],"_links":{"self":[{"href":"https:\/\/haruko.km2m.net\/index.php?rest_route=\/wp\/v2\/posts\/115","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/haruko.km2m.net\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/haruko.km2m.net\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/haruko.km2m.net\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/haruko.km2m.net\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=115"}],"version-history":[{"count":0,"href":"https:\/\/haruko.km2m.net\/index.php?rest_route=\/wp\/v2\/posts\/115\/revisions"}],"wp:attachment":[{"href":"https:\/\/haruko.km2m.net\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=115"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/haruko.km2m.net\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=115"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/haruko.km2m.net\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=115"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}