Wang Y, Liu W, Huang W Y, Lyu R, Li J, Deng S H, Sui W W, Liu H, Wang T Y, Yi S H, Liu H M, Qiu L G, Zou D H
State Key Laboratory of Experimental Hematology, National Clinical Research Center for Blood Diseases, Haihe Laboratory of Cell Ecosystem, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China.
Zhonghua Xue Ye Xue Za Zhi. 2022 Mar 14;43(3):215-220. doi: 10.3760/cma.j.issn.0253-2727.2022.03.006.
This study aimed to determine the efficacy of dose-enhanced immunochemotherapy followed by autologous peripheral blood stem cell transplantation (ASCT) in young patients with newly diagnosed high-risk aggressive B-cell lymphoma. A retrospective study was conducted to examine the clinical and survival data of young patients with high-risk aggressive B-cell lymphoma who received dose-enhanced immunochemotherapy and ASCT as first-line treatment between January 2011 and December 2018 in Blood Diseases Hospital. A total of 63 patients were included in the study. The median age range was 40 (14-63) years old. In terms of the induction therapy regimen, 52 cases received R-DA-EP (D) OCH, and the remaining 11 received R-HyperCVAD/R-MA. Sixteen (25.4% ) patients achieved partial response in the mid-term efficacy assessment, and ten of them were evaluated as complete response after transplantation. The median follow-up was 50 (8-112) months, and the 3-year progression-free survival (PFS) rate and overall survival (OS) rate were (83.9±4.7) % and (90.4±3.7) % , respectively. Univariate analysis demonstrated that age-adjusted international prognostic index ≥2 scores was a negative prognostic factor for OS (=0.039) , and bone marrow involvement (BMI) was an adverse prognostic factor for OS (<0.001) and PFS (=0.001) . However, multivariate analysis confirmed that BMI was the only independent negative predictor of OS (=0.016) and PFS (=0.001) . The use of dose-enhanced immunochemotherapy in combination with ASCT as first-line therapy in the treatment of young, high-risk aggressive B-cell lymphoma results in good long-term outcomes, and BMI remains an adverse prognostic factor.
本研究旨在确定剂量强化免疫化疗后序贯自体外周血干细胞移植（ASCT）对新诊断的高危侵袭性B细胞淋巴瘤年轻患者的疗效。进行了一项回顾性研究，以检查2011年1月至2018年12月期间在血液病医院接受剂量强化免疫化疗和ASCT作为一线治疗的高危侵袭性B细胞淋巴瘤年轻患者的临床和生存数据。共有63例患者纳入研究。中位年龄范围为40（14 - 63）岁。在诱导治疗方案方面，52例接受R-DA-EP（D）OCH，其余11例接受R-HyperCVAD/R-MA。16例（25.4%）患者在中期疗效评估中达到部分缓解，其中10例在移植后评估为完全缓解。中位随访时间为50（8 - 112）个月，3年无进展生存（PFS）率和总生存（OS）率分别为（83.9±4.7）%和（90.4±3.7）%。单因素分析表明，年龄调整后的国际预后指数≥2分是OS的不良预后因素（=0.039），骨髓受累（BMI）是OS（<0.001）和PFS（=0.001）的不良预后因素。然而，多因素分析证实BMI是OS（=0.016）和PFS（=0.001）的唯一独立阴性预测因素。在年轻高危侵袭性B细胞淋巴瘤的治疗中，采用剂量强化免疫化疗联合ASCT作为一线治疗可带来良好的长期预后，且BMI仍然是一个不良预后因素。
