Abu Sabaa Amal, Mörth Charlott, Hasselblom Sverker, Hedström Gustaf, Flogegård Max, Stern Mimmi, Andersson Per-Ola, Glimelius Ingrid, Enblad Gunilla
Centre for Research and Development, Uppsala University/Region Gavleborg, Sweden.
Department of Immunology, Genetics and Pathology, Experimental and Clinical Oncology, Uppsala University, Sweden.
Br J Haematol. 2021 Jun;193(5):906-914. doi: 10.1111/bjh.17206. Epub 2021 May 5.
Routine follow-up for diffuse large B-cell lymphoma have been shortened to 2 years when event-free survival at 24 months (EFS24) emerged as a new milestone. In the present study, we aimed to determine whether the achievement of this milestone affected overall survival (OS). We compared OS to that of an age- and sex-matched population, analysed other factors governing OS, and reviewed the causes of death. Data were collected from the Swedish Cancer Registry and from individual patient's records. We included 1169 adult patients from five counties between the years 2001 and 2014. The median (range) age was 64·6 (18-91) years, 56·6% were men and the median follow-up was 82·3 months. For early stages, the achievement of EFS12 did not improve OS. More than two-thirds of the patients (n = 837, 71·6%) achieved EFS24, of which 190 (22·7%) died during follow-up. Lymphoma (20%), cardiovascular disease (22·4%) and malignancies (16%) contributed to causes of death. Patients aged <60 years had an OS that matched the standard population. In multivariate analysis, only age >60 years significantly affected OS after EFS24 compared with the standard population. We concluded that follow-up beyond EFS24 should be considered for patients aged >60 years.
当24个月无事件生存期(EFS24)成为一个新的里程碑时,弥漫性大B细胞淋巴瘤的常规随访时间已缩短至2年。在本研究中,我们旨在确定这一里程碑的达成是否会影响总生存期(OS)。我们将OS与年龄和性别匹配的人群进行比较,分析影响OS的其他因素,并回顾死亡原因。数据来自瑞典癌症登记处和个体患者记录。我们纳入了2001年至2014年间来自五个县的1169例成年患者。中位(范围)年龄为64.6(18 - 91)岁,56.6%为男性,中位随访时间为82.3个月。对于早期阶段,EFS12的达成并未改善OS。超过三分之二的患者(n = 837,71.6%)实现了EFS24,其中190例(22.7%)在随访期间死亡。淋巴瘤(20%)、心血管疾病(22.4%)和恶性肿瘤(16%)是死亡原因。年龄<60岁的患者的OS与标准人群相当。在多变量分析中,与标准人群相比,只有年龄>60岁在EFS24后对OS有显著影响。我们得出结论,对于年龄>60岁的患者,应考虑在EFS24之后进行随访。