R-CHOP方案治疗后原发性难治性弥漫性大B细胞淋巴瘤患者的预后
Outcome of patients with primary refractory diffuse large B cell lymphoma after R-CHOP treatment.
作者信息
Hitz Felicitas, Connors J M, Gascoyne R D, Hoskins P, Moccia A, Savage K J, Sehn L H, Shenkier T, Villa D, Klasa R
机构信息
Medical Oncology, Oncology/Haematology, Kantonsspital St. Gallen, 9007, St. Gallen, Switzerland.
British Columbia Cancer Agency Centre for Lymphoid Cancer, Vancouver, Canada.
出版信息
Ann Hematol. 2015 Nov;94(11):1839-43. doi: 10.1007/s00277-015-2467-z. Epub 2015 Aug 7.
Primary refractory diffuse large B cell lymphoma (DLBCL) following R-CHOP chemotherapy is a major concern. We identified 1126 patients with DLBCL treated with R-CHOP from 2000 to 2009, of whom 166 (15 %) had primary refractory disease. Of the 75/166 (45 %) who were age <70 years and had been planned for stage-directed curative therapy, 43 (57 %) were primary nonresponders and 32 (43 %) relapsed within 3 months of completing R-CHOP. Thirty of 75 (40 %) patients had serious comorbidity and organ dysfunction precluding intensive treatment and had palliative treatment only. Twelve of 45 (27 %) patients responded to second-line treatment and underwent ASCT. The median overall survival for the 75 patients was 10 months with only seven patients alive without evidence of disease at follow-up ranging from 14 to 106 months. Primary refractory DLBCL after R-CHOP has a very poor outcome with only anecdotal survivors independent of the intended treatment approach.
接受R-CHOP化疗后出现的原发性难治性弥漫性大B细胞淋巴瘤（DLBCL）是一个主要问题。我们确定了2000年至2009年期间接受R-CHOP治疗的1126例DLBCL患者，其中166例（15%）患有原发性难治性疾病。在年龄<70岁且计划进行分期根治性治疗的75/166例（45%）患者中，43例（57%）为原发性无反应者，32例（43%）在完成R-CHOP治疗后3个月内复发。75例患者中有30例（40%）存在严重合并症和器官功能障碍，无法进行强化治疗，仅接受了姑息治疗。45例患者中有12例（27%）对二线治疗有反应并接受了自体造血干细胞移植（ASCT）。这75例患者的中位总生存期为10个月，随访14至106个月时，只有7例患者存活且无疾病证据。R-CHOP治疗后的原发性难治性DLBCL预后非常差，仅有个别幸存者，且与预期的治疗方法无关。
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