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生发中心表型在接受含或不含利妥昔单抗的CHOP样化疗的弥漫性大B细胞淋巴瘤患者中缺乏预后意义。

Lack of prognostic significance of the germinal-center phenotype in diffuse large B-cell lymphoma patients treated with CHOP-like chemotherapy with and without rituximab.

作者信息

Ilić Ivana, Mitrović Zdravko, Aurer Igor, Bašić-Kinda Sandra, Radman Ivo, Ajduković Radmila, Labar Boris, Dotlić Snježana, Nola Marin

机构信息

Department of Pathology and Cytology, University Hospital Center Zagreb, 10000, Zagreb, Croatia.

Division of Hematology, Department of Internal Medicine, University Hospital Center, Medical School University of Zagreb, Zagreb, Croatia.

出版信息

Int J Hematol. 2009 Jul;90(1):74-80. doi: 10.1007/s12185-009-0353-y. Epub 2009 Jun 3.

Abstract

The influence of the germinal-center B-cell (GCB) and the non-GCB phenotypes of diffuse large B-cell lymphoma (DLBCL) on the outcome of 92 patients treated with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) or CHOP-like chemotherapy, with or without rituximab was determined in this study. The differentiation between the GCB and non-GCB types was arrived at by immunohistochemistry using previously published criteria. Thirty-nine patients had the GCB and 53 had the non-GCB type of DLBCL. Forty-nine patients were treated with rituximab and chemotherapy; 43 were treated with chemotherapy alone. The GCB and non-GCB group did not differ in their international prognostic index factors and score, presence of bulky disease, or frequency of rituximab treatment. Median follow-up of the surviving patients was carried out for 37 months. There was no difference between the GCB and non-GCB groups in both overall response rates (67 vs. 70%, respectively) and estimated rates of 3-year event-free (46 vs. 49%, respectively) and overall (54 vs. 56%, respectively) survival. In addition, no differences of the outcomes were observed between the subgroups treated with or without rituximab. The patients of this study with immunohistochemically determined GCB-type DLBCL did not have an improved prognosis, irrespective of whether they had received rituximab or not.

摘要

本研究确定了弥漫性大B细胞淋巴瘤(DLBCL)的生发中心B细胞(GCB)和非GCB表型对92例接受环磷酰胺、多柔比星、长春新碱和泼尼松(CHOP)或类似CHOP化疗(无论是否联合利妥昔单抗)患者预后的影响。采用先前公布的标准,通过免疫组织化学方法区分GCB和非GCB类型。39例患者为GCB型DLBCL,53例为非GCB型DLBCL。49例患者接受利妥昔单抗和化疗;43例仅接受化疗。GCB组和非GCB组在国际预后指数因素和评分、大包块疾病的存在或利妥昔单抗治疗频率方面无差异。对存活患者进行了37个月的中位随访。GCB组和非GCB组在总缓解率(分别为67%和70%)、估计3年无事件生存率(分别为46%和49%)和总生存率(分别为54%和56%)方面均无差异。此外,在接受或未接受利妥昔单抗治疗的亚组之间未观察到结局差异。本研究中经免疫组织化学确定为GCB型DLBCL的患者,无论是否接受利妥昔单抗治疗,其预后均未改善。

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