Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China.
Clin Exp Med. 2024 Mar 1;24(1):48. doi: 10.1007/s10238-024-01306-2.
Despite great advances in treatment, 30-40% of patients with DLBCL undergo relapses. Patients with a relapse within 1 year or beyond have a distinct outcome. Few clinical characteristics and survival data in the Chinese population have been published. We aimed to define the incidence and clinical features of DLBCL patients with very early relapse after front-line immunochemotherapy who may benefit greatly from the emerging chimeric antigen receptor T-cell therapy. Data of 564 DLBCL patients were analyzed. Among the 413 patients achieving a first complete remission, 59 underwent relapses: 32 patients (54.2%) relapsed within 1 year, and 27 patients (46.8%) relapsed 1 year or more. Patients relapsing within 1 year, in comparison with the other group, showed an inferior risk profile at diagnosis: elevated lactate dehydrogenase level (P = 0.002), high Eastern Cooperative Oncology Group performance score (P = 0.02), and high international prognosis index (P = 0.004). As expected, a worse overall survival was observed in the early relapse group. Multivariate analysis for OS showed that relapse within 1 year was an independent parameter for reduced overall survival (HR 0.241, P = 0.002).
尽管在治疗方面取得了重大进展,但仍有 30-40%的弥漫性大 B 细胞淋巴瘤(DLBCL)患者会复发。在 1 年内或 1 年以后复发的患者具有明显不同的结局。目前在中国人群中公布的临床特征和生存数据很少。我们旨在定义一线免疫化疗后非常早期复发的 DLBCL 患者的发生率和临床特征,这些患者可能会从新兴的嵌合抗原受体 T 细胞疗法中受益匪浅。分析了 564 例 DLBCL 患者的数据。在 413 例达到首次完全缓解的患者中,有 59 例复发:32 例(54.2%)在 1 年内复发,27 例(46.8%)在 1 年或更长时间后复发。与其他组相比,在 1 年内复发的患者在诊断时的风险状况较差:乳酸脱氢酶水平升高(P=0.002)、东部肿瘤协作组表现评分较高(P=0.02)和国际预后指数较高(P=0.004)。正如预期的那样,早期复发组的总体生存率较低。OS 的多变量分析显示,1 年内复发是总生存时间降低的独立参数(HR 0.241,P=0.002)。