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亚洲原发性中枢神经系统淋巴瘤患者接受化疗后静脉血栓栓塞症的发生率和特征。

Incidence and characteristics of venous thromboembolism in Asian patients with primary central nervous system lymphoma undergoing chemotherapy.

机构信息

Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea.

Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea.

出版信息

Thromb Res. 2019 Nov;183:131-135. doi: 10.1016/j.thromres.2019.10.002. Epub 2019 Oct 20.

Abstract

BACKGROUND

Venous thromboembolism (VTE) may lead to diminished quality of life and ultimately worse prognosis in cancer patients, but there is limited data on the incidence, risk factors and mortality impact of VTE in Asian primary central nervous system lymphoma (PCNSL) patients.

OBJECTIVES

To report the incidence, risk factors and mortality impact of VTE in Asian PCNSL patients.

METHODS

From 7 academic centers in Korea, 235 newly diagnosed PCNSL patients undergoing chemotherapy were retrospectively identified during period of January 2004 to September 2018.

RESULTS

All patients but 12 (6 T-cell, 6 other B-cell) had diffuse large B-cell lymphoma. During the median follow-up of 21 months, 33 patient (14.0%) developed VTE. Of the VTE events, 11 (33.3%) were deep vein thrombosis (DVT), 15 (45.5%) were pulmonary thromboembolism (PTE), and 7 (21.2%) were DVT with PTE. The median time to VTE was 2 months and the one-year actuarial incidence was 11.7%. On multivariate analysis, ECOG performance ≥2, age >60 years, female sex, and Hb <10 g/dL were independently associated with VTE. The patients with VTE were associated with shorter disease specific survival (P = 0.046) and overall survival (P = 0.022).

CONCLUSION

Overall, the incidence of VTE in Asian PCNSL seems to be lower compared to Western population. As VTE development is associated with overall survival and indicative of relapse, careful close monitoring is warranted.

摘要

背景

静脉血栓栓塞症(VTE)可能导致癌症患者生活质量下降,最终预后更差,但亚洲原发性中枢神经系统淋巴瘤(PCNSL)患者 VTE 的发生率、危险因素和死亡率影响的数据有限。

目的

报告亚洲 PCNSL 患者 VTE 的发生率、危险因素和死亡率影响。

方法

从 2004 年 1 月至 2018 年 9 月,在韩国的 7 个学术中心,回顾性地确定了 235 名接受化疗的新诊断 PCNSL 患者。

结果

所有患者均为弥漫性大 B 细胞淋巴瘤,除 12 例(6 例 T 细胞,6 例其他 B 细胞)外。在中位随访 21 个月期间,33 例患者(14.0%)发生了 VTE。VTE 事件中,11 例(33.3%)为深静脉血栓形成(DVT),15 例(45.5%)为肺血栓栓塞症(PTE),7 例(21.2%)为 DVT 合并 PTE。VTE 的中位时间为 2 个月,一年累积发生率为 11.7%。多变量分析显示,ECOG 表现≥2、年龄>60 岁、女性和 Hb<10g/dL 与 VTE 独立相关。发生 VTE 的患者疾病特异性生存率(P=0.046)和总生存率(P=0.022)更短。

结论

总体而言,亚洲 PCNSL 患者 VTE 的发生率似乎低于西方人群。由于 VTE 的发生与总生存率相关,并提示复发,因此需要密切监测。

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