2 型糖尿病使接受 (R)-CHOP 治疗的弥漫性大 B 细胞淋巴瘤患者的生存受到影响——PLRG 报告。
Type 2 diabetes mellitus compromises the survival of diffuse large B-cell lymphoma patients treated with (R)-CHOP - the PLRG report.
机构信息
Department of Hematology, Oncology and Internal Diseases, Medical University of Warsaw, Banacha 1a Str, 02-097, Warszawa, Poland.
Department of Hematology and Transplantology, Medical University of Gdansk, Smoluchowskiego 17 Str., 80-214, Gdansk, Poland.
出版信息
Sci Rep. 2020 Feb 26;10(1):3517. doi: 10.1038/s41598-020-60565-7.
Comorbidities impair the prognosis of diffuse large B-cell lymphoma (DLBCL). Type 2 diabetes mellitus (DMT2) increases the risk of other comorbidities, e.g., heart failure (HF). Thus, we hypothesized that pre-existing DMT2 may negatively affect the outcome of DLBCL. To verify this, DLBCL patients treated with (R)-CHOP were enrolled. 469 patients were eligible, with a median age of 57 years; 356 patients had advanced-stage DLBCL. 126 patients had high-intermediate and 83 high-risk international prognostic index (IPI). Seventy-six patients had DMT2, 46 HF; 26 patients suffered from both DMT2 and HF. In the analyzed group DMT2 or HF significantly shortened overall survival (OS) and progression free survival (PFS): the 5-year OS for patients with DMT2 was 64% vs 79% and for those with HF: 49% vs 79%. The 5-year PFS for DMT2 was 50.6% vs 62.5% and for HF 39.4% vs 63.2%. The relapse/progression incidence was comparable between groups; the non-relapse/progression mortality (NRPM) was significantly higher solely in DMT2 patients (5-year NRPM 22.5% vs 8.4%). The risk of death was higher in patients with higher IPI (HR = 1.85) and with DMT2 (HR = 1.87). To conclude, pre-existing DMT2, in addition to a higher IPI and HF, was a negative predictor for OS and PFS.
合并症会影响弥漫性大 B 细胞淋巴瘤 (DLBCL) 的预后。2 型糖尿病 (DMT2) 会增加其他合并症的风险，例如心力衰竭 (HF)。因此，我们假设先前存在的 DMT2 可能会对 DLBCL 的结果产生负面影响。为了验证这一点，我们招募了接受 (R)-CHOP 治疗的 DLBCL 患者。符合条件的患者有 469 名，中位年龄为 57 岁；356 名患者为晚期 DLBCL。126 名患者为高中危国际预后指数 (IPI)，83 名患者为高危 IPI。76 名患者患有 DMT2，46 名患者患有 HF；26 名患者同时患有 DMT2 和 HF。在分析的组中，DMT2 或 HF 显著缩短了总生存期 (OS) 和无进展生存期 (PFS)：患有 DMT2 的患者的 5 年 OS 为 64%，而无 DMT2 的患者为 79%；患有 HF 的患者的 5 年 OS 为 49%，而无 HF 的患者为 79%。DMT2 患者的 5 年 PFS 为 50.6%，而 HF 患者为 39.4%；无 HF 的患者为 63.2%。两组的复发/进展发生率相当；仅在 DMT2 患者中，非复发/进展死亡率 (NRPM) 显著更高（5 年 NRPM 为 22.5%，而 8.4%）。在 IPI 较高的患者（HR=1.85）和患有 DMT2 的患者（HR=1.87）中，死亡风险更高。总之，除了较高的 IPI 和 HF 之外，先前存在的 DMT2 也是 OS 和 PFS 的负面预测因子。
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