Alsuliman Tamim, Stocker Nicolas, Corre Elise, Dulery Rémy, Sestili Simona, Ricard Laure, Malard Florent, Mohty Mohamad, Coppo Paul, Marjanovic Zora
Sorbonne University, Paris, France.
Service d'Hématologie Clinique et Thérapie Cellulaire, Hôpital Saint-Antoine, AP-HP, Paris, France.
Bone Marrow Transplant. 2023 Apr;58(4):437-439. doi: 10.1038/s41409-022-01902-4. Epub 2022 Dec 22.
Patients with high-risk lymphoma have a poor prognosis when treated with standard chemoimmunotherapy. This retrospective study included 23 high-risk lymphoma patients with a median age at diagnosis of 59 (range, 35-68) years. They received 2 cycles of R-COPADM and 2 cycles of CYVE, completed by ASCT for fit patients. With a median follow-up of 46 (range, 3-78) months, three (13%) patients in the cohort died. Nearly half of the patients had an ECOG performance status of 2 or 3. Most patients in the cohort (91%, n = 21) had Ann Arbor stage III-IV disease, and 88% (n = 20) had an IPI of 3 to 5. LDH levels were elevated in 83% (n = 19) of patients. Overall, 30% of patients were identified as having double-expressor lymphoma and 22% as having DHL, while two patients (9%) had THL. The origin of the lymphoma was GC B-cell-like in 15 patients (65%) and ABC-like in 8 patients (35%). Cumulative incidence of relapse at 46 months was 14% (95% CI, 5-37), while overall survival was 87% (95% CI, 64-95) and progression-free survival was 83% (95% CI, 60-93). These results showed the efficacy and an acceptable safety profile of the R-COPADM/CYVE/ASCT regimen in high-risk lymphoma, including patients with DHL.
高危淋巴瘤患者接受标准化学免疫治疗时预后较差。这项回顾性研究纳入了23例高危淋巴瘤患者，诊断时的中位年龄为59岁（范围35 - 68岁）。他们接受了2个周期的R - COPADM和2个周期的CYVE，适合的患者随后接受自体干细胞移植（ASCT）。中位随访46个月（范围3 - 78个月），队列中有3例（13%）患者死亡。近一半患者的东部肿瘤协作组（ECOG）体能状态为2或3。队列中的大多数患者（91%，n = 21）处于Ann Arbor III - IV期疾病，88%（n = 20）的国际预后指数（IPI）为3至5。83%（n = 19）的患者乳酸脱氢酶（LDH）水平升高。总体而言，30%的患者被确定为双表达淋巴瘤，22%为双打击淋巴瘤（DHL），而2例患者（9%）为三打击淋巴瘤（THL）。淋巴瘤起源于生发中心B细胞样的有15例患者（65%），起源于活化B细胞样的有8例患者（35%）。46个月时的累积复发率为14%（95%置信区间，5 - 37），总生存率为87%（95%置信区间，64 - 95），无进展生存率为83%（95%置信区间，60 - 93）。这些结果显示了R - COPADM/CYVE/ASCT方案在高危淋巴瘤（包括DHL患者）中的疗效和可接受的安全性。
