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治疗后浆母细胞淋巴瘤患者的生存分析:一项基于人群的研究。

Survival analysis in treated plasmablastic lymphoma patients: a population-based study.

机构信息

Division of Hospital Medicine, Miller School of Medicine, University of Miami, Miami, Florida.

Divison of Hematology, Department of Medicine, Sylvester Comprehensive Cancer Center, Miller School of Medicine, University of Miami, Miami, Florida.

出版信息

Am J Hematol. 2020 Nov;95(11):1344-1351. doi: 10.1002/ajh.25955. Epub 2020 Aug 26.

Abstract

Herein we analyzed survival outcomes in chemotherapy-treated patients with plasmablastic lymphoma (PBL) diagnosed between 2010 to 2016 (n = 248). Data was acquired from the Surveillance, Epidemiology, and End Results (SEER) 18 registries database (April 2019 release based on November 2018 submission). The majority of patients were male (81.9%) and younger than 60 years (71.0%). Oral and gastrointestinal (GI) sites were the most frequent primary extranodal locations (23% and 19.4%, respectively). Oral primary location was inversely associated with presence of B symptoms and advanced Ann-Arbor stage. The 3-year and 5-year overall survival (OS) rates of treated PBL patients were 54% (95% CI: 46.5%-60.8%) and 52.8% (95% CI: 45.2%-59.8%). Three-year conditional survival for 2-year and 3-year survivors were 90.3% and 97.8%, overlapping the survival of a general population matched by age, sex and calendar year. In a multivariable analysis, oral primary location was associated with not only better OS (HR 0.43; 95% CI: 0.21-0.88, P = .021) but also better lymphoma-specific survival (LSS) (SHR 0.36; 95% CI: 0.15-0.86, P = .022); age ≥60 years was associated with shorter LSS (SHR 1.73; 95% CI: 1.02-2.96, P = .043). Seven registries granted access to HIV status (n = 93) where HIV infection was detected in 52.7% of cases. The HIV status did not affect survival outcomes in unadjusted and adjusted analyses. We identified clinical characteristics associated with survival and showed that treated PBL patients may achieve long-term survival.

摘要

在此,我们分析了 2010 年至 2016 年间诊断为 plasmablastic lymphoma (PBL) 的接受化疗的患者的生存结果(n = 248)。数据来自 Surveillance, Epidemiology, and End Results (SEER) 18 个登记数据库(基于 2018 年 11 月提交的 2019 年 4 月版本)。大多数患者为男性(81.9%),年龄小于 60 岁(71.0%)。口腔和胃肠道(GI)是最常见的原发性结外部位(分别为 23%和 19.4%)。口腔原发性部位与 B 症状和晚期 Ann-Arbor 分期的存在呈负相关。经治疗的 PBL 患者的 3 年和 5 年总生存率(OS)分别为 54%(95%CI:46.5%-60.8%)和 52.8%(95%CI:45.2%-59.8%)。2 年和 3 年幸存者的 3 年条件生存率分别为 90.3%和 97.8%,与年龄、性别和日历年龄相匹配的一般人群的生存率重叠。在多变量分析中,口腔原发性部位不仅与更好的 OS(HR 0.43;95%CI:0.21-0.88,P =.021)相关,而且与更好的淋巴瘤特异性生存率(LSS)(SHR 0.36;95%CI:0.15-0.86,P =.022)相关;年龄≥60 岁与较短的 LSS 相关(SHR 1.73;95%CI:1.02-2.96,P =.043)。有 7 个登记处获得了 HIV 状态(n = 93)的数据,其中 52.7%的病例检测到 HIV 感染。在未调整和调整后的分析中,HIV 状态均未影响生存结果。我们确定了与生存相关的临床特征,并表明接受治疗的 PBL 患者可能实现长期生存。

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