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中国 10 年间 80 岁以上弥漫性大 B 细胞淋巴瘤患者的临床特征、治疗模式和结局。

Clinical characteristics, treatment patterns and outcomes of patients older than 80 years diagnosed with DLBCL in China over a 10-year period.

机构信息

Department of Medical Oncology, Hua'Dong Hospital Affiliated to Fudan University, Shanghai, 200040, China.

Department of Radiation Oncology, Hua'Dong Hospital Affiliated to Fudan University, Room 403, 6th Building, No. 221, Yan'an West Road, Shanghai, 200040, China.

出版信息

Cancer Chemother Pharmacol. 2019 Jul;84(1):127-137. doi: 10.1007/s00280-019-03859-6. Epub 2019 May 13.

Abstract

PURPOSE

The treatment strategy for elderly patients older than 80 years with DLBCL has not been defined yet because of poor treatment tolerability and lack of data. The aim of this trial was to retrospectively investigate clinical characteristics, treatment patterns and outcomes of patients older than 80 years diagnosed with DLBCL in China over a 10-year period.

METHODS

This trial comprised 57 patients, aged ≥ 80 years, who were initial diagnosed as diffuse large B-cell lymphoma from 2007 to 2017. They received at least four cycles of reduced-dose R-CHOP21 (Rituximab 375 mg/m day 0, Cyclophosphamide 400 mg/m day1, Epirubicin 35 mg/m day 1, Vincristine 1 mg day 1, and Prednisone 50 mg/m days 1-5). An observational population-based, cohort study was performed.

RESULTS

The median age was 82.5 years (range 80-90 years ) and the overall response rate was 73.7%. With a median 36.4-month follow-up, 2-year overall survival (OS) and 2-year progression-free survival were 74.3% and 70.9%, respectively. Using rigorous multivariate analysis, we concluded that NCCN-IPI ≥ 5 was the only predictive poor prognostic factor.

CONCLUSIONS

High response rate was concluded on very elderly DLBCL patients (≥ 80 years old) with reduced-dose R-CHOP. However, the very elderly patients with NCCN-IPI score ≥ 5 would lead to poor outcome.

摘要

目的

由于治疗耐受性差和缺乏数据,80 岁以上老年弥漫性大 B 细胞淋巴瘤(DLBCL)患者的治疗策略尚未确定。本研究旨在回顾性分析 10 年来中国 80 岁以上初诊为 DLBCL 患者的临床特征、治疗模式和结局。

方法

该试验纳入了 2007 年至 2017 年期间诊断为弥漫性大 B 细胞淋巴瘤且年龄≥80 岁的 57 例患者。他们接受了至少 4 个周期的低剂量 R-CHOP21(利妥昔单抗 375mg/m2,第 0 天;环磷酰胺 400mg/m2,第 1 天;表柔比星 35mg/m2,第 1 天;长春新碱 1mg,第 1 天;泼尼松 50mg/m2,第 1-5 天)治疗。进行了一项基于观察的人群队列研究。

结果

中位年龄为 82.5 岁(范围 80-90 岁),总缓解率为 73.7%。中位随访 36.4 个月后,2 年总生存率(OS)和 2 年无进展生存率分别为 74.3%和 70.9%。通过严格的多变量分析,我们得出结论,NCCN-IPI≥5 是唯一的不良预后预测因素。

结论

对于年龄非常大(≥80 岁)的 DLBCL 患者,低剂量 R-CHOP 可获得较高的缓解率。然而,NCCN-IPI 评分≥5 的非常老年患者预后较差。

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