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新诊断为弥漫性大 B 细胞淋巴瘤患者的生存结局:来自德国索赔数据库的真实世界证据。

Survival outcomes of patients newly diagnosed with diffuse large B-cell lymphoma: real-world evidence from a German claims database.

机构信息

Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Medical Faculty and University Hospital Cologne, Cologne, Germany.

Miltenyi Biomedicine, Friedrich-Ebert-Straße 68, 51429, Bergisch Gladbach, Germany.

出版信息

J Cancer Res Clin Oncol. 2023 Aug;149(10):7091-7101. doi: 10.1007/s00432-023-04660-y. Epub 2023 Mar 5.

Abstract

PURPOSE

Diffuse large B-cell lymphoma (DLBCL) is the most common subtype of non-Hodgkin lymphoma with increasing incidence. Although the burden of disease is high, only limited current real-world data on survival analysis, especially survival time, of German patients with DLBCL are available. This retrospective claims-based analysis was conducted to describe real-world survival evidence and treatment patterns of patients with DLBCL in Germany.

METHODS

Using a large claims database of the German statutory health insurance with 6.7 million enrollees, we identified patients between 2010 and 2019 who were newly diagnosed with DLBCL (index date) and had no other cancer co-morbidity. Overall survival (OS) from index date and from the end of each treatment line was plotted by means of the Kaplan-Meier estimator, both for the overall cohort and stratified by treatment regimen. Treatment lines were identified based on a predefined set of medications categorized by established DLBCL treatment recommendations.

RESULTS

2495 incident DLBCL patients were eligible for the study. After index date, 1991 patients started a first-line, 868 a second-line, and 354 a third-line therapy. In first line, 79.5% of patients received a Rituximab-based therapy. 5.0% of the of the 2495 patients received a stem cell transplantation. Overall, median OS after index was 96.0 months.

CONCLUSION

DLBCL-associated mortality is still high, especially in relapsed patients and in the elderly. Therefore, there is a high medical need for new effective treatments that can improve survival outcomes in DLBCL patients.

摘要

目的

弥漫性大 B 细胞淋巴瘤(DLBCL)是非霍奇金淋巴瘤中最常见的亚型,发病率不断上升。尽管疾病负担很高,但目前仅有限的德国 DLBCL 患者生存分析,特别是生存时间的真实世界数据可用。本回顾性基于索赔的分析旨在描述德国 DLBCL 患者的真实世界生存证据和治疗模式。

方法

使用德国法定健康保险的大型索赔数据库,该数据库拥有 670 万参保人,我们确定了 2010 年至 2019 年期间新诊断为 DLBCL(索引日期)且无其他癌症合并症的患者。使用 Kaplan-Meier 估计值绘制从索引日期和每个治疗线结束的总生存(OS),包括整个队列和按治疗方案分层的 OS。根据既定 DLBCL 治疗建议分类的一组预定义药物,确定治疗线。

结果

符合条件的 2495 例 DLBCL 患者入选本研究。索引日期后,1991 例患者开始一线治疗,868 例患者开始二线治疗,354 例患者开始三线治疗。在一线治疗中,79.5%的患者接受了基于利妥昔单抗的治疗。2495 例患者中有 5.0%接受了干细胞移植。总体而言,索引后中位 OS 为 96.0 个月。

结论

DLBCL 相关死亡率仍然很高,尤其是在复发患者和老年人中。因此,对于能够改善 DLBCL 患者生存结果的新有效治疗方法存在很高的医疗需求。

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