Department of Medicine, Alpert Medical School of Brown University, Providence, RI, USA.
Division of Hematology and Oncology, Rhode Island Hospital, Providence, RI, USA.
Leuk Lymphoma. 2019 Dec;60(14):3426-3433. doi: 10.1080/10428194.2019.1639166. Epub 2019 Jul 9.
Using data from the National Cancer Data Base, 2010-2015, we examined characteristics and outcomes of T-cell/histiocyte-rich large B-cell lymphoma (THRLBCL, = 622) relative to unspecified diffuse large B-cell lymphoma (DLBCL-NOS, = 91,588) and nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL, = 2240). Socio-demographic characteristics of patients with THRLBCL resembled more NLPHL than DLBCL-NOS. Five-year overall survival in THRLBCL was 66% (95% confidence interval [CI], 60-71%). Adjusting for clinical and socio-economic covariates, THRLBCL was associated with better survival than DLBCL-NOS (adjusted hazard ratio, 0.80; 95%CI, 0.67-0.94). This association was similar in academic and community hospitals and consistent in a model stratified by the revised International Prognostic Index. Prognostic factors in THRLBCL included age, comorbidity index, and extranodal primary site, but not stage. Adjusted odds of prior NLPHL were 18.2 higher for THRLBCL (95%CI, 7.2-45.7) than DLBCL-NOS. These large-scale epidemiologic data support the relationship between THRLBCL and NLPHL, and suggest improved prognosis with modern rituximab-based immunochemotherapy.
利用国家癌症数据库 2010-2015 年的数据,我们考察了 T 细胞/组织细胞丰富型大 B 细胞淋巴瘤(THRLBCL,=622)相对于未特指弥漫性大 B 细胞淋巴瘤(DLBCL-NOS,=91588)和结节性淋巴细胞为主型霍奇金淋巴瘤(NLPHL,=2240)的特征和结局。THRLBCL 患者的社会人口统计学特征与 NLPHL 更相似,而不是 DLBCL-NOS。THRLBCL 的 5 年总生存率为 66%(95%置信区间[CI],60-71%)。调整临床和社会经济协变量后,THRLBCL 的生存情况优于 DLBCL-NOS(调整后的危险比,0.80;95%CI,0.67-0.94)。这种关联在学术和社区医院中相似,在修订后的国际预后指数分层模型中也是一致的。THRLBCL 的预后因素包括年龄、合并症指数和结外原发部位,但不包括分期。THRLBCL 发生前 NLPHL 的调整比值比为 18.2(95%CI,7.2-45.7),高于 DLBCL-NOS。这些大规模的流行病学数据支持 THRLBCL 与 NLPHL 之间的关系,并表明现代利妥昔单抗为基础的免疫化疗可改善预后。