George E Wahlen Veterans Health Administration, Salt Lake City, UT 84148, USA.
VERITAS, Division of Epidemiology, University of Utah, Salt Lake City, UT 84112, USA.
Future Oncol. 2021 Feb;17(4):411-422. doi: 10.2217/fon-2020-0522. Epub 2020 Oct 29.
To describe practices and outcomes in veterans with relapsed/refractory diffuse large B-cell lymphoma. Using Veteran Affairs Cancer Registry System and electronic health record data, we identified relapsed/refractory diffuse large B-cell lymphoma patients completing second-line treatment (2L) in 2000-2016. Treatments were classified as aggressive/nonaggressive. Analyses included descriptive statistics and the Kaplan-Meier estimation of progression-free survival and overall survival. Two hundred and seventy patients received 2L. During median 9.7-month follow-up starting from 2L, 470 regimens were observed, averaging 2.7 regimens/patient: 219 aggressive, 251 nonaggressive. One hundred and twenty-one patients proceeded to third-line, 50 to fourth-line and 18 to fifth-line treatment. Median progression-free survival in 2L was 5.2 months. Median overall survival was 9.5 months. Forty-four patients (16.3%) proceeded to bone marrow transplant. More effective, less toxic treatments are needed and should be initiated earlier in treatment trajectory.
描述退伍军人复发性/难治性弥漫性大 B 细胞淋巴瘤的治疗方法和结局。利用退伍军人事务部癌症登记系统和电子健康记录数据，我们确定了 2000 年至 2016 年间完成二线治疗（2L）的复发性/难治性弥漫性大 B 细胞淋巴瘤患者。治疗方法分为侵袭性/非侵袭性。分析包括描述性统计和无进展生存期和总生存期的 Kaplan-Meier 估计。270 名患者接受了 2L 治疗。从 2L 开始，中位随访 9.7 个月期间，观察到 470 种方案，平均每个患者 2.7 种方案：219 种侵袭性方案，251 种非侵袭性方案。121 名患者接受了三线治疗，50 名患者接受了四线治疗，18 名患者接受了五线治疗。2L 时的中位无进展生存期为 5.2 个月。中位总生存期为 9.5 个月。44 名患者（16.3%）接受了骨髓移植。需要更有效、毒性更小的治疗方法，并且应该在治疗过程中更早地开始。
