Sorigue Marc, Garcia Olga, Baptista Maria Joao, Sancho Juan-Manuel, Tapia Gustavo, Mate José Luis, Feliu Evarist, Navarro José-Tomás, Ribera Josep-Maria
Departamento de Hematología, Hospital ICO-Germans Trias i Pujol, Instituto de Investigación contra la Leucemia Josep Carreras, Universitat Autònoma de Barcelona, Badalona, Barcelona, España.
Departamento de Patología, Hospital Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Barcelona, España.
Med Clin (Barc). 2017 Mar 22;148(6):243-249. doi: 10.1016/j.medcli.2016.09.050. Epub 2016 Dec 27.
The prognosis of diffuse large B-cell lymphomas (DLBCL) transformed from indolent lymphoma (TL) has been considered poorer than that of de novo DLBCL. However, it seems to have improved since the introduction of rituximab.
We compared the characteristics (including the cell-of-origin), and the prognosis of 29 patients with TL and 101 with de novo DLBCL treated with immunochemotherapy.
Patients with TL and de novo DLBCL had similar characteristics. All TL cases evolving from follicular lymphoma were germinal-center B-cell-like, while those TL from marginal zone lymphoma or chronic lymphocytic leukemia were non-germinal-center B-cell-like. The complete response rate was similar in TL and de novo DLBCL (62 vs. 66%, P=.825). The 5-year overall and progression-free survival probabilities (95% CI) were 59% (40-78) and 41% (22-60) for TL and 63% (53-73) and 60% (50-70) for de novo DLBCL, respectively (P=.732 for overall survival and P=.169 for progression-free survival).
In this study, the prognosis of TL and de novo DLBCL treated with immunochemotherapy was similar. The role of intensification with stem cell transplantation in the management of TL may be questionable in the rituximab era.
惰性淋巴瘤转化而来的弥漫性大B细胞淋巴瘤（DLBCL）的预后被认为比原发性DLBCL更差。然而，自利妥昔单抗应用以来，其预后似乎有所改善。
我们比较了29例惰性淋巴瘤转化型DLBCL患者和101例原发性DLBCL患者接受免疫化疗后的特征（包括起源细胞）及预后。
惰性淋巴瘤转化型DLBCL患者和原发性DLBCL患者具有相似的特征。所有由滤泡性淋巴瘤演变而来的惰性淋巴瘤转化型DLBCL病例均为生发中心B细胞样，而那些由边缘区淋巴瘤或慢性淋巴细胞白血病演变而来的惰性淋巴瘤转化型DLBCL病例则为非生发中心B细胞样。惰性淋巴瘤转化型DLBCL和原发性DLBCL的完全缓解率相似（分别为62%和66%，P = 0.825）。惰性淋巴瘤转化型DLBCL的5年总生存率和无进展生存率（95%CI）分别为59%（40 - 78）和41%（22 - 60），原发性DLBCL分别为63%（53 - 73）和60%（50 - 70）（总生存率P = 0.732，无进展生存率P = 0.169）。
在本研究中，接受免疫化疗的惰性淋巴瘤转化型DLBCL和原发性DLBCL的预后相似。在利妥昔单抗时代，强化干细胞移植在惰性淋巴瘤转化型DLBCL治疗中的作用可能存在疑问。
