Li Jiayin, Liu Xiaoyin, Yao Zhihua, Zhang Mingzhi
Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan 450000, People's Republic of China.
Lymphoma Diagnosis and Treatment Center of Henan Province, Zhengzhou, Henan 450000, Republic of China.
Cancer Manag Res. 2020 Mar 13;12:1903-1912. doi: 10.2147/CMAR.S243753. eCollection 2020.
To analyze the clinical and pathological characteristics, treatment, and prognosis of high-grade B-cell lymphomas, not otherwise specified (HGBL, NOS), and to increase awareness of this type of lymphoma.
We collected clinical and pathological data of 41 cases of newly diagnosed HGBL, NOS, and analyzed diagnosis, prognosis and treatment to examine progression-free survival (PFS) and overall survival (OS).
Among the 41 cases studied, the median PFS was 6.0 months and the median OS was 18.0 months. Compared with patients treated with the R-CHOP regimen, patients treated with a high-intensity chemotherapy (DA-EPOCH-R, R-CODOX-M/IVAC, or R-Hyper-CVAD) had superior PFS and OS (PFS: χ=4.173, =0.041; OS: χ=5.200, =0.023). A subgroup analysis showed that the OS for the double-expressor lymphoma (DEL) was inferior to that for the non-DEL (χ=4.563, =0.033), and this trend was also seen for the single-hit lymphoma with rearrangement (SHL) and the non-SHL (χ=4.955, =0.026). Patients with low International Prognostic Index (IPI) scores (≤2) had better survival rates than those with high scores (>2) (PFS: χ=6.482, =0.011; OS: χ=10.156, =0.001).
HGBL, NOS is associated with a high degree of malignancy, short survival period, and substantial extranodal involvement. High-intensity chemotherapy may improve patient prognosis. While IPI scores statistically correlated with the prognosis, SHL and DEL correlated with an inferior survival rate. New and improved treatments will be needed for HGBL, NOS.
分析未另行指定的高级别B细胞淋巴瘤（HGBL，NOS）的临床和病理特征、治疗及预后情况，以提高对这类淋巴瘤的认识。
我们收集了41例新诊断的HGBL，NOS患者的临床和病理数据，并分析其诊断、预后及治疗情况，以检测无进展生存期（PFS）和总生存期（OS）。
在研究的41例患者中，中位PFS为6.0个月，中位OS为18.0个月。与接受R-CHOP方案治疗的患者相比，接受高强度化疗（DA-EPOCH-R、R-CODOX-M/IVAC或R-Hyper-CVAD）的患者具有更好的PFS和OS（PFS：χ=4.173，P=0.041；OS：χ=5.200，P=0.023）。亚组分析显示，双表达淋巴瘤（DEL）的OS低于非DEL（χ=4.563，P=0.033），在有 重排的单打击淋巴瘤（SHL）和非SHL中也观察到这种趋势（χ=4.955，P=0.026）。国际预后指数（IPI）评分低（≤2）的患者生存率高于评分高（>2）的患者（PFS：χ=6.482，P=0.011；OS：χ=10.156，P=0.001）。
HGBL，NOS具有高度恶性、生存期短及大量结外受累的特点。高强度化疗可能改善患者预后。虽然IPI评分与预后有统计学相关性，但SHL和DEL与较差的生存率相关。HGBL，NOS需要新的和改进的治疗方法。
