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自体造血干细胞移植治疗非霍奇金淋巴瘤患者的预后因素:单中心经验。

Prognostic factors in non-Hodgkin's lymphoma patients treated by autologous stem cell transplantation: a single center experience.

机构信息

Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

出版信息

Cancer Res Treat. 2005 Oct;37(5):294-301. doi: 10.4143/crt.2005.37.5.294. Epub 2005 Oct 31.

Abstract

PURPOSE

Autologous stem cell transplantation (ASCT) is increasingly used in patients with non-Hodgkin's lymphoma (NHL). Various clinical parameters-were evaluated to obtain significant predictors of the outcome following ASCT in patients with NHL.

MATERIALS AND METHODS

Between April 1994 and December 2003, ASCT was performed on 80 patients with NHL at the Asan Medical Center.

RESULTS

Patients had various histological subtypes and disease status. The two year progression free survival (PFS) and overall survival for all patients were 34 and 31%, respectively. A univariate analysis showed the performance status, stage, modified extranodal involvement category, International Prognostic Index (IPI) at mobilization, disease status at mobilization, and history of radiation prior to mobilization as significant predictors of the outcome following ASCT. Four risk groups, with different 2 year PFS, were identified by the age adjusted IPI at mobilization (mAAIPI): low risk 44%; low intermediate risk 40%; high intermediate risk 19%; and high risk 0% (p=.0003). A multivariate analysis revealed 3 significant factors for the PFS: disease status, prior RT and mAAIPI.

CONCLUSION

The mAAIPI was found to be an independent predictor of the outcome of NHL patients undergoing ASCT. This powerful prognostic tool should be used to evaluate potential candidates for ASCT.

摘要

目的

自体干细胞移植(ASCT)在非霍奇金淋巴瘤(NHL)患者中越来越多地使用。评估了各种临床参数,以获得 NHL 患者 ASCT 后结局的显著预测因素。

材料和方法

1994 年 4 月至 2003 年 12 月,在 Asan 医疗中心对 80 例 NHL 患者进行了 ASCT。

结果

患者具有不同的组织学亚型和疾病状态。所有患者的 2 年无进展生存(PFS)和总生存分别为 34%和 31%。单因素分析显示,表现状态、分期、改良结外累及类别、动员时的国际预后指数(IPI)、动员时的疾病状态以及动员前的放射史是 ASCT 后结局的显著预测因素。通过动员时的年龄调整 IPI(mAAIPI)确定了 4 个具有不同 2 年 PFS 的风险组:低危组 44%;低中危组 40%;高中危组 19%;高危组 0%(p=.0003)。多因素分析显示 PFS 的 3 个显著因素:疾病状态、既往 RT 和 mAAIPI。

结论

mAAIPI 是接受 ASCT 的 NHL 患者结局的独立预测因素。这种强大的预后工具应用于评估接受 ASCT 的潜在候选者。

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