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在利妥昔单抗时代,弥漫性大 B 细胞淋巴瘤诊断时绝对淋巴细胞和单核细胞计数的预后影响。

The prognostic impact of absolute lymphocyte and monocyte counts at diagnosis of diffuse large B-cell lymphoma in the rituximab era.

机构信息

Department of Hematology and Clinical Immunology, Kobe City Medical Center General Hospital, Kobe, Japan.

出版信息

Acta Haematol. 2013;130(4):242-6. doi: 10.1159/000350484. Epub 2013 Jul 11.

Abstract

BACKGROUND

A recent report showed that the combination of the absolute lymphocyte count (ALC) and the absolute monocyte count (AMC) at diagnosis gave a prognostic score in diffuse large B-cell lymphoma (DLBCL). However, this model requires validation in other patient cohorts.

METHODS

We retrospectively evaluated the prognostic impact of the combination of the ALC and the AMC at diagnosis in a cohort of 299 DLBCL patients who were treated in the rituximab era at a single institution.

RESULTS

In univariate analyses, an ALC ≤1.0 × 10(9)/l [4-year overall survival (OS) rate 47.0 vs. 79.4%; p < 0.001] and an AMC ≥0.63 × 10(9)/l (4-year OS rate 52.4 vs. 75.6%; p < 0.001) were associated with inferior OS, respectively. In multivariate analyses, an ALC ≤1.0 × 10(9)/l and an AMC ≥0.63 × 10(9)/l were significantly associated with inferior OS independently of the International Prognostic Index. Furthermore, the combination of ALC and AMC could identify patients with the dismal prognosis; the 4-year OS rates for patients with ALC ≤1.0 × 10(9)/l and AMC ≥0.63 × 10(9)/l were 18.8%.

CONCLUSIONS

The combination of ALC and AMC at diagnosis may be useful for the prognostic stratification of patients with DLBCL.

摘要

背景

最近的一份报告显示,在弥漫性大 B 细胞淋巴瘤(DLBCL)患者中,诊断时绝对淋巴细胞计数(ALC)和绝对单核细胞计数(AMC)的组合可提供预后评分。然而,该模型需要在其他患者队列中进行验证。

方法

我们回顾性评估了在单中心接受利妥昔单抗治疗的 299 例 DLBCL 患者队列中,诊断时 ALC 和 AMC 组合对预后的影响。

结果

在单因素分析中,ALC≤1.0×10(9)/l[4 年总生存率(OS)率为 47.0% vs. 79.4%;p<0.001]和 AMC≥0.63×10(9)/l(4 年 OS 率为 52.4% vs. 75.6%;p<0.001)与较差的 OS 相关。在多因素分析中,ALC≤1.0×10(9)/l 和 AMC≥0.63×10(9)/l 独立于国际预后指数与较差的 OS 显著相关。此外,ALC 和 AMC 的组合可识别预后不良的患者;ALC≤1.0×10(9)/l 和 AMC≥0.63×10(9)/l 的患者 4 年 OS 率为 18.8%。

结论

诊断时 ALC 和 AMC 的组合可能有助于 DLBCL 患者的预后分层。

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