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华氏巨球蛋白血症预后因素的回顾性分析:日本一项多中心合作研究

Retrospective analysis of prognostic factors for Waldenstrӧm macroglobulinemia: a multicenter cooperative study in Japan.

作者信息

Saito Akio, Isoda Atsushi, Kojima Masaru, Yokohama Akihiko, Tsukune Yutaka, Sasaki Makoto, Ito Shigeki, Ohtsu Akihiro, Koike Michiaki, Murayama Kayoko, Moriya Keiichi, Tamura Hideto, Matsumoto Morio, Nakahashi Hirotaka, Tanosaki Sakae, Sakura Tohru, Kawamura Toshihide, Miyanaga Tomomi, Nakamura Naoya, Murakami Hirokazu, Handa Hiroshi, Tsukamoto Norifumi

机构信息

Department of Hematology, Fujioka General Hospital, Gunma, Japan.

Department of Hematology, National Hospital Organization Shibukawa Medical Center, 383 Shiroi, Shibukawa, Gunma Prefecture, 377-0280, Japan.

出版信息

Int J Hematol. 2017 Nov;106(5):681-690. doi: 10.1007/s12185-017-2297-y. Epub 2017 Jul 7.

Abstract

Although population-based cancer registries have reported lower incidence of Waldenstrӧm macroglobulinemia (WM) in East Asia than in Western countries, previous retrospective analyses have found the clinical features of WM to be similar in these two populations. To clarify the characteristics of Japanese WM patients, we retrospectively analyzed clinical and laboratory characteristics, treatments, outcomes, and prognostic factors in 93 patients with WM. Based on the Second International Workshop on WM (IWWM-2) criteria, symptomatic WM was found in 73 (78.5%) and asymptomatic WM in 20 (21.5%) of cases examined. The median overall survival (OS) was similar to that in reports from Western countries. Patients receiving treatment regimens including rituximab exhibited significantly better survival than those not given rituximab. Although prognostic factors for WM in Western countries may not apply to Japanese patients, our finding that newly diagnosed WM patients with pleural effusion have a poorer prognosis suggests that this may be a novel predictor of adverse prognosis in symptomatic WM.

摘要

尽管基于人群的癌症登记处报告称,东亚地区华氏巨球蛋白血症(WM)的发病率低于西方国家,但以往的回顾性分析发现,这两个人群中WM的临床特征相似。为了阐明日本WM患者的特征,我们回顾性分析了93例WM患者的临床和实验室特征、治疗情况、预后及预后因素。根据第二届WM国际研讨会(IWWM-2)标准,在所检查的病例中,73例(78.5%)为有症状WM,20例(21.5%)为无症状WM。中位总生存期(OS)与西方国家的报告相似。接受包括利妥昔单抗在内治疗方案的患者生存率明显高于未接受利妥昔单抗治疗的患者。尽管西方国家WM的预后因素可能不适用于日本患者,但我们发现新诊断的有胸腔积液的WM患者预后较差,这表明这可能是有症状WM不良预后的一个新的预测指标。

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