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诊断时可溶性白细胞介素-2 受体水平对接受 ABVD 联合或不联合放疗的经典霍奇金淋巴瘤患者结局的预测价值。

Predictive value of soluble interlukin-2 receptor level at diagnosis on the outcome for patients with classical Hodgkin lymphoma treated with ABVD with or without radiotherapy.

机构信息

Division of Hematology, Department of Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi, 329-0498, Japan.

出版信息

Ann Hematol. 2019 Sep;98(9):2121-2129. doi: 10.1007/s00277-019-03738-3. Epub 2019 Jun 25.

Abstract

We retrospectively analyzed 70 patients with classical Hodgkin lymphoma (cHL) who were treated with doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) with or without radiotherapy to assess the influence of the soluble interleukin-2 receptor (sIL-2R) level at diagnosis on the clinical outcome. Receiver operating characteristic analyses determined that the optimal cutoff value of the sIL-2R level for progression-free survival (PFS) was 2490 U/mL. Using this cutoff value, patients were classified into low (n = 46) and high (n = 24) sIL-2R groups. The patients in the high sIL-2R group exhibited a significantly inferior PFS (44.1% vs. 90.4% at 5 years, P < 0.001) and overall survival (OS) (67.6% vs. 94.7% at 5 years, P = 0.001) compared with those in the low sIL-2R group. Multivariate analysis showed that a high sIL-2R level was an independent prognostic factor for PFS after adjusting for stage, white blood cell, hemoglobin, and B symptoms, and also OS after adjusting for age and stage (hazard ratio (HR) 6.49, P < 0.001 and HR 5.98, P = 0.009, respectively). In patients with advanced-stage cHL, a high sIL-2R level predicted 5-year PFS even after adjustment for international prognostic score > 4 (HR 6.00, P = 0.007). These results demonstrate that the sIL-2R level can be a useful prognostic factor in patients with cHL treated with ABVD with or without radiotherapy.

摘要

我们回顾性分析了 70 例接受阿霉素、博来霉素、长春碱和达卡巴嗪(ABVD)联合或不联合放疗的经典霍奇金淋巴瘤(cHL)患者,以评估诊断时可溶性白细胞介素 2 受体(sIL-2R)水平对临床结局的影响。接受者操作特征分析确定,无进展生存(PFS)的 sIL-2R 水平最佳截断值为 2490 U/mL。使用该截断值,患者被分为低(n=46)和高(n=24)sIL-2R 组。高 sIL-2R 组患者的 PFS(5 年时分别为 44.1%和 90.4%,P<0.001)和总生存(OS)(5 年时分别为 67.6%和 94.7%,P=0.001)明显低于低 sIL-2R 组。多变量分析显示,在校正分期、白细胞、血红蛋白和 B 症状后,高 sIL-2R 水平是 PFS 的独立预后因素,在校正年龄和分期后,也是 OS 的独立预后因素(危险比(HR)6.49,P<0.001 和 HR 5.98,P=0.009)。在晚期 cHL 患者中,即使在校正国际预后评分>4 后,高 sIL-2R 水平仍可预测 5 年 PFS(HR 6.00,P=0.007)。这些结果表明,sIL-2R 水平可作为接受 ABVD 联合或不联合放疗的 cHL 患者的有用预后因素。

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