Avilés A, Díaz-Maqueo J C, Rodríguez L, García E L, Torras V, Guzmán R
Departamento de Hematología, Hospital de Oncología, Centro Médico Nacional, IMSS México, D.F.
Arch Invest Med (Mex). 1990 Jan-Mar;21(1):11-6.
Between 1980 and 1982, 162 patients with non-Hodgkin's lymphoma were treated with cyclophosphamide, adriamycin, vincristine and prednisone (CHOP) or CHOP plus bleomycin. At the moment when the patient were diagnosed all clinical characteristics were evaluated according to a multiple regression analysis model, which has the following three factors associated to bad prognosis: a quick clinical evolution (less than three months) bone marrow infiltration and high levels of lactate dehydrogenase (LDH). The Cox model of analysis also agreed that a quick clinical evolution and the high levels of LDH were bad prognosis factors. These two factors were associated with poor complete remission and short survival rates. A mathematical model was built based on the last two factors. Five groups of patients were observed with increasing risk of a poor response and a short survival rates, which allowed us to identified three prognostic groups with clear differences in both the duration of remission and survival. These groups were low, moderate and high-risk. Results analysis in this paper have important clinical implications for the design of the prospective clinical trials in patients with malignant lymphoma.
1980年至1982年间，162例非霍奇金淋巴瘤患者接受了环磷酰胺、阿霉素、长春新碱和泼尼松（CHOP）或CHOP加博来霉素治疗。在患者确诊时，根据多元回归分析模型对所有临床特征进行评估，该模型有以下三个与预后不良相关的因素：临床进展迅速（少于三个月）、骨髓浸润和乳酸脱氢酶（LDH）水平高。Cox分析模型也认为临床进展迅速和LDH水平高是预后不良因素。这两个因素与完全缓解率低和生存率短有关。基于最后两个因素建立了一个数学模型。观察到五组患者反应不佳和生存率短的风险增加，这使我们能够确定三个预后组，其缓解期和生存期有明显差异。这些组为低、中、高危组。本文的结果分析对恶性淋巴瘤患者前瞻性临床试验的设计具有重要的临床意义。
