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韩国霍奇金淋巴瘤的临床特征和结局:改善淋巴瘤生存联盟 (CISL)。

Clinical features and outcomes of Hodgkin's lymphoma in Korea: Consortium for Improving Survival of Lymphoma (CISL).

机构信息

Hematology-Oncology Clinic, Research Institute and Hospital, National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 410-769, Republic of Korea.

出版信息

Ann Hematol. 2012 Feb;91(2):223-33. doi: 10.1007/s00277-011-1297-x. Epub 2011 Jul 26.

Abstract

Ethnic and regional differences in the epidemiology and pathological aspects of Hodgkin's lymphoma (HL) between Western and Asian patients may be associated with differences in clinical features and prognosis. We retrospectively analyzed the clinical and histopathological characteristics, therapeutic outcomes, and prognostic factors of 539 HL patients treated at 16 centers in Korea. We found that the incidence of histological subtypes of HL in Korea was similar to that in Western and other Asian countries. However, the incidence peaked between 16 and 30 years of age, unlike the bimodal age distribution seen in Western countries. In patients with stage I-IIA non-bulky disease, the complete response (CR) rate was similar between combined modality therapy and chemotherapy alone (93% vs. 84%, P = 0.44), and there was no difference in relapse-free survival (RFS) and overall survival (OS). Patients with stage I-II disease plus unfavorable factors and those with advanced-stage disease treated with combination chemotherapy regimens had an overall CR rate of 77%, with no difference between doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) and non-ABVD regimens (77.2% vs. 76.8%, P = 0.95). Among those patients who achieved final CR, there was no significant difference in RFS or OS between those who achieved interim CR and PR. Only the presence of B symptoms was independently predictive of a shorter RFS. Age > 45 years, Eastern Cooperative Oncology Group 2-4, and B symptoms were independent risk factors for death. Although the incidence of HL was lower in Korea than in Western countries, the distribution of morphological subtypes, treatment outcomes, and patient prognosis were similar.

摘要

在西方和亚洲患者中,霍奇金淋巴瘤(HL)的流行病学和病理学方面的种族和地区差异可能与临床特征和预后的差异有关。我们回顾性分析了韩国 16 个中心治疗的 539 例 HL 患者的临床和组织病理学特征、治疗结果和预后因素。我们发现韩国 HL 的组织学亚型发生率与西方和其他亚洲国家相似。然而,发病年龄高峰在 16 至 30 岁之间,与西方国家所见的双峰年龄分布不同。在 I-IIA 期非肿块性疾病患者中,联合治疗和单纯化疗的完全缓解(CR)率相似(93%对 84%,P=0.44),无复发生存(RFS)和总生存(OS)无差异。I-II 期疾病加不良因素的患者和接受联合化疗方案治疗的晚期疾病患者的总体 CR 率为 77%,阿霉素、博莱霉素、长春碱和达卡巴嗪(ABVD)与非 ABVD 方案之间无差异(77.2%对 76.8%,P=0.95)。在那些达到最终 CR 的患者中,达到临时 CR 和 PR 的患者的 RFS 或 OS 无显著差异。只有 B 症状的存在是 RFS 较短的独立预测因素。年龄>45 岁、东部合作肿瘤学组 2-4 级和 B 症状是死亡的独立危险因素。尽管韩国 HL 的发病率低于西方国家,但形态亚型的分布、治疗结果和患者预后相似。

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