Byrd Kenneth P, Vontela Namratha R, McCullar Brennan, Martin Mike G
Department of Hematology/Oncology, University of Tennessee Health Science Center, Memphis, TN, U.S.A.
The West Cancer Center, Memphis, TN, U.S.A.
Anticancer Res. 2017 Dec;37(12):6839-6843. doi: 10.21873/anticanres.12145.
BACKGROUND/AIM: Stage I splenic diffuse large B-cell lymphoma (DLBCL) is rare and there are few data to guide management. We sought to further define prognosis and outcomes.
We utilized the Surveillance, Epidemiology, and End Results registry to identify patients with stage I splenic DLBCL diagnosed 1973-2013. Patients were divided into two cohorts based on the year of diagnosis (1983-2005; 2006-2013) as rituximab was approved by the U.S. Food and Drug Administration in 2006 for first-line treatment of DLBCL.
Utilization of splenectomy decreased after the approval of rituximab (82% pre- versus 72% rituximab-era). Disease-specific and overall survival were greater with splenectomy [hazard ratio (HR)=0.57, p=0.04; and HR=0.66, p=0.03, respectively], but this benefit was only seen in the pre-rituximab cohort, not in the rituximab-era cohort. There was a trend toward improved overall survival with the introduction of rituximab (HR=0.75, p=0.054).
Utilization of splenectomy for stage I splenic DLBCL has decreased with the introduction of rituximab without compromising outcomes.
背景/目的：Ⅰ期脾弥漫性大B细胞淋巴瘤（DLBCL）较为罕见，可供指导治疗的数据较少。我们试图进一步明确其预后和结局。
我们利用监测、流行病学和最终结果登记系统，确定1973 - 2013年期间诊断为Ⅰ期脾DLBCL的患者。根据诊断年份（1983 - 2005年；2006 - 2013年）将患者分为两个队列，因为利妥昔单抗于2006年被美国食品药品监督管理局批准用于DLBCL的一线治疗。
利妥昔单抗获批后，脾切除术的使用率有所下降（利妥昔单抗应用前为82%，利妥昔单抗时代为72%）。脾切除术后疾病特异性生存率和总生存率更高[风险比（HR）=0.57，p = 0.04；HR = 0.66，p = 0.03]，但这种益处仅在利妥昔单抗应用前的队列中可见，在利妥昔单抗时代的队列中未观察到。随着利妥昔单抗的引入，总生存率有改善趋势（HR = 0.75，p = 0.054）。
随着利妥昔单抗的引入，Ⅰ期脾DLBCL的脾切除术使用率有所下降，且未影响治疗结局。
