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美国浆母细胞淋巴瘤的流行病学特征、治疗模式和生存分析:SEER 和 NCDB 分析。

Epidemiologic Characteristics, Treatment Patterns, and Survival Analysis of Plasmablastic Lymphoma in the United States: A SEER and NCDB Analysis.

机构信息

Department of Internal Medicine, University of Utah, Salt Lake City, UT.

Department of Internal Medicine, University of Utah, Salt Lake City, UT; Division of Hematology and Hematologic Malignancies, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT.

出版信息

Clin Lymphoma Myeloma Leuk. 2024 Apr;24(4):e152-e160.e3. doi: 10.1016/j.clml.2023.12.014. Epub 2023 Dec 25.

Abstract

BACKGROUND

Plasmablastic Lymphoma (PBL) is a rare aggressive B-cell lymphoma that primarily affects immunocompromised individuals, including those living with HIV. Historically, survival estimates are dismal and range from 8 to 15 months. We aimed to evaluate epidemiologic characteristics, treatment patterns and survival trends on a national scale.

PATIENTS AND METHODS

Patients diagnosed with PBL from 2010 to 2020 were identified in the National Cancer Database (NCDB) and in the Surveillance, Epidemiology, and End Results (SEER) program. Incidence rates were calculated using SEER. Demographic features, treatment characteristics, and overall survival (OS) were identified using the NCDB.

RESULTS

We identified 1153 patients in the SEER database and 1822 patients in the NCDB. The incidence of PBL is 0.07 cases per 100,000 US population per year. PBL is more common in males (77%), and white patients (77%), with 50% of cases in patients with HIV. Patients who were treated with multiagent chemotherapy had a median OS of 58.6 months. On multivariate Cox regression, we found that HIV status did not have a significant impact on OS. Factors associated with worse OS included advancing age and stage.

CONCLUSION

We present the largest study to date on PBL. Among treated patients, we described a median OS of 58.6 months, greatly improved from previously reported estimates. We found that HIV status did not have a significant impact on OS. While OS remains poor, therapeutic advances over the last decade are promising and highlight the need for continued clinical advances aimed at improving therapeutic options for this rare lymphoma.

摘要

背景

浆母细胞淋巴瘤(PBL)是一种罕见的侵袭性 B 细胞淋巴瘤,主要影响免疫功能低下的个体,包括 HIV 感染者。历史上,生存率令人沮丧,范围在 8 至 15 个月之间。我们旨在评估全国范围内的流行病学特征、治疗模式和生存趋势。

患者和方法

在国家癌症数据库(NCDB)和监测、流行病学和最终结果(SEER)计划中,确定了 2010 年至 2020 年期间诊断为 PBL 的患者。使用 SEER 计算发病率。使用 NCDB 确定人口统计学特征、治疗特征和总生存(OS)。

结果

我们在 SEER 数据库中识别出 1153 例患者,在 NCDB 中识别出 1822 例患者。PBL 的发病率为每年每 10 万美国人口 0.07 例。PBL 在男性(77%)和白人患者(77%)中更为常见,50%的病例发生在 HIV 患者中。接受多药化疗的患者的中位 OS 为 58.6 个月。在多变量 Cox 回归中,我们发现 HIV 状态对 OS 没有显著影响。与 OS 较差相关的因素包括年龄增长和分期。

结论

我们提出了迄今为止关于 PBL 的最大研究。在接受治疗的患者中,我们描述了中位 OS 为 58.6 个月,与之前报告的估计值相比有了很大改善。我们发现 HIV 状态对 OS 没有显著影响。虽然 OS 仍然较差,但过去十年的治疗进展令人鼓舞,这突显了需要不断进行临床进展,以改善这种罕见淋巴瘤的治疗选择。

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