Yu Wen-Yan, Geng Mei, Hao Jie, Chen Mei, Zhang Su-Jiang, Wang Jin, Mi Jian-Qing
Shanghai Institute of Hematology, Rui Jin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Oncology, Rui Jin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Clin Lymphoma Myeloma Leuk. 2017 May;17(5):274-282. doi: 10.1016/j.clml.2017.02.005. Epub 2017 Feb 17.
There is little information available regarding Chinese patients with Hodgkin lymphoma (HL). We analyzed the clinical features, outcome, and prognostic factors of Chinese patients with HL, aiming to establish a new risk model for better risk-adapted therapeutic strategy.
Patients with newly diagnosed HL at 4 medical centers from January 2000 to August 2014 were recruited.
A total of 150 patients were reviewed. The median age was 30 years (range, 15-91 years). At completion of initial therapy, 73.65% of patients achieved complete remission. The 5-year event-free survival (EFS) of the entire cohort was 61.1%, the overall survival was 84.7%, and the disease-free survival was 78.8%. B symptoms, extranodal involvement, and International Prognostic Score ≥ 3 remained as independent prognostic factors of EFS. Patients who failed to reach complete remission on interim positron emission tomography/computed tomography or computed tomography had a significantly worse outcome than those who did. A new risk model incorporating traditional risk factors and interim response stratified patients into 3 classes, with a 5-year EFS of 100%, 83.1%, and 33.1%, respectively (P < .0001).
General clinical features were comparable with those of Western patients, whereas therapeutic outcomes were slightly inferior. The novel risk assessment model showed potential as a more powerful prognostic tool by identifying 3 subsets of patients with significantly distinct outcomes, which warrants further validations.
关于中国霍奇金淋巴瘤(HL)患者的可用信息较少。我们分析了中国HL患者的临床特征、结局及预后因素,旨在建立一种新的风险模型,以制定更好的风险适应性治疗策略。
招募了2000年1月至2014年8月期间在4家医疗中心新诊断为HL的患者。
共纳入150例患者进行回顾性分析。中位年龄为30岁(范围15 - 91岁)。初始治疗结束时,73.65%的患者达到完全缓解。整个队列的5年无事件生存率(EFS)为61.1%,总生存率为84.7%,无病生存率为78.8%。B症状、结外受累及国际预后评分≥3仍是EFS的独立预后因素。在中期正电子发射断层扫描/计算机断层扫描或计算机断层扫描时未达到完全缓解的患者,其结局明显差于达到完全缓解的患者。一种结合传统风险因素和中期反应的新风险模型将患者分为3组,5年EFS分别为100%、83.1%和33.1%(P <.0001)。
中国HL患者的总体临床特征与西方患者相当,但治疗结局略差。这种新的风险评估模型通过识别3组结局显著不同的患者,显示出作为一种更强大的预后工具的潜力,值得进一步验证。