R-CHOP 治疗弥漫性大 B 细胞淋巴瘤患者的绝对单核细胞和淋巴细胞预后指数。
The absolute monocyte and lymphocyte prognostic index for patients with diffuse large B-cell lymphoma who receive R-CHOP.
机构信息
Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY, USA.
出版信息
Clin Lymphoma Myeloma Leuk. 2013 Feb;13(1):15-8. doi: 10.1016/j.clml.2012.09.009. Epub 2012 Nov 6.
BACKGROUND
The baseline absolute monocyte count and absolute lymphocyte count were used to generate a prognostic index (the AMLPI) for survival in diffuse large B-cell lymphoma (DLBCL).
METHODS
Data from 245 patients with DLBCL who were treated with standard R-CHOP (rituximab, cyclophosphamide, doxorubicin hydrochloride, vincristine sulfate, prednisone) were reviewed. By using the values previously reported for the AMLPI, its prognostic value was examined in our population.
RESULTS
After a median follow-up of 22 months for censored observations, the 3-year progression-free survival (PFS) rates for the international prognostic index (IPI) 0-2 and 3-5 risk groups were 73% and 58%, respectively (P = .0004); comparable overall survival (OS) rates were 88% and 68%, respectively (P < .0001). For patients with IPI scores of 0-2, 1-year PFS rates for AMLPI low-, intermediate-, and high-risk groups were 92%, 89%, and 80%, respectively (P = .022); comparable 1-year OS rates were 96%, 95%, and 80%, respectively (P = .049). By multivariate analysis, with the adjustment of IPI in the model, AMLPI effects (low- vs. high-risk groups) on PFS and OS rates were significant, with P = .046 (hazard ratio [HR] 0.402 [95% CI, 0.164-0.986] and P = .052 (HR 0.325 [95% CI, 0.104-1.011]), respectively.
CONCLUSIONS
The absolute monocyte and lymphocyte counts prognostic index (the AMLPI) may add prognostic value beyond that of the IPI for patients with DLBCL who receive R-CHOP.
背景
基线绝对单核细胞计数和绝对淋巴细胞计数被用于生成弥漫性大 B 细胞淋巴瘤（DLBCL）的生存预后指数（AMLPI）。
方法
对 245 例接受标准 R-CHOP（利妥昔单抗、环磷酰胺、盐酸多柔比星、硫酸长春新碱、泼尼松）治疗的 DLBCL 患者的数据进行了回顾。根据先前报道的 AMLPI 值，在本研究人群中检验了其预后价值。
结果
在对删失观察进行中位数为 22 个月的随访后，国际预后指数（IPI）0-2 分和 3-5 分风险组的 3 年无进展生存（PFS）率分别为 73%和 58%（P=0.0004）；相应的总生存（OS）率分别为 88%和 68%（P<0.0001）。对于 IPI 评分为 0-2 分的患者，AMLPI 低、中、高危组的 1 年 PFS 率分别为 92%、89%和 80%（P=0.022）；相应的 1 年 OS 率分别为 96%、95%和 80%（P=0.049）。多变量分析显示，在模型中调整 IPI 后，AMLPI 对 PFS 和 OS 率的影响具有统计学意义（P=0.046，危险比 [HR]0.402[95%可信区间，0.164-0.986]和 P=0.052，HR 0.325[95%可信区间，0.104-1.011]）。
结论
对于接受 R-CHOP 治疗的 DLBCL 患者，绝对单核细胞和淋巴细胞计数预后指数（AMLPI）可能比 IPI 提供更多的预后价值。
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