Department of Oncology and Radiotherapy, Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru; Centro de Investigación de Medicina de Precisión, Universidad de San Martin de Porres, Lima, Peru.
Department of Oncology and Radiotherapy, Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru; Centro de Investigación de Medicina de Precisión, Universidad de San Martin de Porres, Lima, Peru.
Leuk Res. 2021 Mar;102:106513. doi: 10.1016/j.leukres.2021.106513. Epub 2021 Jan 23.
Data on response and survival outcomes of Latin American patients with diffuse Large B- cell lymphoma (DLBCL) are limited. We describe the clinical, inflammatory and immunohistochemical features of a cohort of DLBCL Peruvian patients treated with chemoimmunotherapy between 2010 and 2015. Logistic models were fitted for complete response (CR), and Cox proportional-hazard regression for progression-free survival (PFS) and overall survival (OS). Seventy-three patients were included in this analysis, 41 % had high/high-intermediate IPI and 48 % had high/high-intermediate NCCN-IPI scores, 41 % had non-germinal center (NGC) profile and 36 % were double expressors. CR was attained in 63 % of patients, median PFS was 53 months and median OS was 80 months. Both IPI and NCCN-IPI scores were statistically associated with PFS and OS. Neutrophil/lymphocyte ratio (NLR) ≥4 was associated with lower odds of CR (OR 0.19, p = 0.007), worse PFS (HR 2.67, p = 0.02) and worse OS (HR 2.77, p = 0.02). NLR ≥ 4 remained significant after adjusting for the IPI score and had a trend towards significance when adjusted for the NCCN-IPI score. Albumin <3.5 g/dl was associated with worse OS when adjusted for the NCCN-IPI score (HR 2.96, p = 0.04). NGC profile and double expressors were not prognostic. Our study identified NLR ≥ 4 and albumin <3.5 g/dl as potential adverse factors in DLBCL patients and could add to the prognostic value of the IPI or the NCCN-IPI scores.
关于拉丁美洲弥漫性大 B 细胞淋巴瘤 (DLBCL) 患者的反应和生存结果的数据有限。我们描述了一组在 2010 年至 2015 年期间接受化疗免疫治疗的秘鲁 DLBCL 患者的临床、炎症和免疫组织化学特征。逻辑模型用于完全缓解 (CR),Cox 比例风险回归用于无进展生存期 (PFS) 和总生存期 (OS)。本分析共纳入 73 例患者,41%患者国际预后指数 (IPI) 高/中高危,48%患者 NCCN-IPI 评分高/中高危,41%患者非生发中心 (NGC) 型,36%患者为双表达型。63%的患者达到了 CR,中位 PFS 为 53 个月,中位 OS 为 80 个月。IPI 和 NCCN-IPI 评分均与 PFS 和 OS 有统计学关联。中性粒细胞/淋巴细胞比值 (NLR)≥4 与较低的 CR 几率 (OR 0.19,p=0.007)、较差的 PFS (HR 2.67,p=0.02) 和较差的 OS (HR 2.77,p=0.02) 相关。NLR≥4 在调整 IPI 评分后仍然显著,在调整 NCCN-IPI 评分后有显著趋势。白蛋白 <3.5 g/dl 与 NCCN-IPI 评分调整后的 OS 较差相关 (HR 2.96,p=0.04)。NGC 型和双表达型与预后无关。本研究确定 NLR≥4 和白蛋白 <3.5 g/dl 为 DLBCL 患者的潜在不良因素,并可能增加 IPI 或 NCCN-IPI 评分的预后价值。