First Department of Internal Medicine, Gifu University Graduate School of Medicine, Gifu, Japan.
Eur J Haematol. 2013 Oct;91(4):322-31. doi: 10.1111/ejh.12139. Epub 2013 Jul 7.
Serum soluble tumor necrosis factor receptor 2 (sTNFR2) concentration predicted the clinical outcome of patients with aggressive non-Hodgkin's lymphoma including diffuse large B-cell lymphoma (DLBCL) treated with CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisolone) in our previous study. However, after rituximab (R) was introduced in clinical practice, R-CHOP replaced CHOP as the standard therapy for DLBCL.
In this study, we re-evaluated the prognostic significance of serum sTNFR2 in 154 patients with DLBCL treated with R-CHOP.
Five-yr overall survival (5-yr OS) rates with sTNFR2 ≥20 ng/mL and <20 ng/mL were 29.2% and 83.3% (P < 0.0001), respectively, and the corresponding 5-yr progression-free survival (5-yr PFS) rates were 26.9% and 76.4% (P < 0.0001), respectively. A multivariate analysis revealed that serum sTNFR2 and complete remission (CR) were independent prognostic factors for both OS (CR: P < 0.0001, sTNFR2: P = 0.0001) and PFS (CR: P < 0.0001, sTNFR2: P = 0.0001). The prognosis of patients with poor risk groups according to the revised International Prognostic Index who also had high serum sTNFR2 was especially poor.
Serum sTNFR2 might be a powerful prognostic factor for patients with DLBCL in the rituximab era.
在我们之前的研究中，血清可溶性肿瘤坏死因子受体 2（sTNFR2）浓度可预测接受 CHOP（环磷酰胺、多柔比星、长春新碱和泼尼松）治疗的侵袭性非霍奇金淋巴瘤患者，包括弥漫性大 B 细胞淋巴瘤（DLBCL）的临床预后。然而，利妥昔单抗（R）引入临床实践后，R-CHOP 取代 CHOP 成为 DLBCL 的标准治疗方法。
在这项研究中，我们重新评估了 154 例接受 R-CHOP 治疗的 DLBCL 患者血清 sTNFR2 的预后意义。
sTNFR2≥20ng/mL 和<20ng/mL 的 5 年总生存率（5-yr OS）分别为 29.2%和 83.3%（P<0.0001），相应的 5 年无进展生存率（5-yr PFS）分别为 26.9%和 76.4%（P<0.0001）。多变量分析显示，血清 sTNFR2 和完全缓解（CR）是 OS（CR：P<0.0001，sTNFR2：P=0.0001）和 PFS（CR：P<0.0001，sTNFR2：P=0.0001）的独立预后因素。根据修订后的国际预后指数，属于不良风险组且血清 sTNFR2 较高的患者预后尤其差。
血清 sTNFR2 可能是利妥昔单抗时代 DLBCL 患者的一个强有力的预后因素。
