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新冠病毒肺炎合并淋巴瘤住院患者的预后决定因素:一项回顾性多中心队列研究。

Determinants of outcome in Covid-19 hospitalized patients with lymphoma: A retrospective multicentric cohort study.

作者信息

Lamure Sylvain, Duléry Rémy, Di Blasi Roberta, Chauchet Adrien, Laureana Cécile, Deau-Fischer Bénédicte, Drenou Bernard, Soussain Carole, Rossi Cédric, Noël Nicolas, Choquet Sylvain, Bologna Serge, Joly Bertrand, Kohn Milena, Malak Sandra, Fouquet Guillemette, Daguindau Etienne, Bernard Sophie, Thiéblemont Catherine, Cartron Guillaume, Lacombe Karine, Besson Caroline

机构信息

Département d'Hématologie Clinique, CHU de Montpellier, UMR-CNRS 5535, Université de Montpellier, Montpellier, France.

Service d'Hématologie Clinique et de Thérapie Cellulaire, Hôpital Saint Antoine, Assistance Publique - Hôpitaux de Paris, Inserm UMRs 938, Sorbonne Université, Paris, France.

出版信息

EClinicalMedicine. 2020 Oct;27:100549. doi: 10.1016/j.eclinm.2020.100549. Epub 2020 Oct 13.

Abstract

BACKGROUND

Patients with lymphoma are immunocompromised because of the disease and its treatments. We aimed to describe the characteristics of patients with lymphoma hospitalized for Coronavirus Disease 2019 (Covid-19) and to analyze pre-Covid-19 determinants of mortality.

METHODS

This retrospective multicentric cohort study used the database to identify all adult patients with lymphoma, hospitalized for Covid-19 in March and April 2020, in 12 hospitals of three French regions with pandemic outbreaks. The characteristics of lymphoma and Covid-19 were collected from medical charts.

FINDINGS

Eighty-nine patients were included. The median age was 67 years (range, 19-92), 66% were male and 72% had a comorbidity. Most patients had B-cell non-Hodgkin lymphoma (86%) and had received a lymphoma treatment within one year (70%). With a median follow-up of 33 days from admission, 30-day overall survival was 71%, (95% confidence interval, 62-81%). In multivariable analysis, having an age ≥ 70 years (hazard ratio 2·87, 1·20-6·85,  = 0·02) and relapsed/refractory lymphoma (hazard ratio 2·54, 1·14-5·66,  = 0·02) were associated with mortality. Recent bendamustine treatment ( = 9) was also pejorative (hazard ratio 3·20, 1·33-7·72,  = 0·01), but was strongly associated with relapsed/refractory lymphoma. Remarkably, 30-day overall survival for patients < 70 years of age without relapsed/refractory lymphoma was 88% (78% - 99%).

INTERPRETATION

Thirty-day mortality was associated with being older and relapsed/refractory lymphoma. Survival of patients younger than 70 years without relapsed/refractory lymphoma was comparable to that of the general population.

FUNDING

There have been no specific funds to run this study.

摘要

背景

淋巴瘤患者由于疾病及其治疗而免疫功能低下。我们旨在描述因2019冠状病毒病(Covid-19)住院的淋巴瘤患者的特征,并分析Covid-19前的死亡决定因素。

方法

这项回顾性多中心队列研究使用数据库识别2020年3月和4月在法国三个有疫情爆发地区的12家医院因Covid-19住院的所有成年淋巴瘤患者。从病历中收集淋巴瘤和Covid-19的特征。

结果

纳入89例患者。中位年龄为67岁(范围19 - 92岁),66%为男性,72%有合并症。大多数患者患有B细胞非霍奇金淋巴瘤(86%),且在一年内接受过淋巴瘤治疗(70%)。从入院起中位随访33天,30天总生存率为71%(95%置信区间,62 - 81%)。在多变量分析中,年龄≥70岁(风险比2.87,1.20 - 6.85,P = 0.02)和复发/难治性淋巴瘤(风险比2.54,1.14 - 5.66,P = 0.02)与死亡率相关。近期使用苯达莫司汀治疗(n = 9)也有不良影响(风险比3.20,1.33 - 7.72,P = 0.01),但与复发/难治性淋巴瘤密切相关。值得注意的是,年龄<70岁且无复发/难治性淋巴瘤患者的30天总生存率为88%(78% - 99%)。

解读

30天死亡率与年龄较大和复发/难治性淋巴瘤有关。年龄小于70岁且无复发/难治性淋巴瘤患者的生存率与一般人群相当。

资金

本研究没有特定资金支持。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b3ab/7599303/be168569229d/gr1.jpg

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