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原发性胃弥漫大 B 细胞淋巴瘤:一项多中心回顾性研究。

Primary gastric diffuse large B-cell lymphoma: A multicentre retrospective study.

机构信息

Department of Haematology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia.

Department of Haematology, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, Victoria, Australia.

出版信息

Br J Haematol. 2024 Aug;205(2):534-541. doi: 10.1111/bjh.19470. Epub 2024 Apr 17.

Abstract

Primary gastric diffuse large B-cell lymphoma (PG-DLBCL) accounts for the majority of extra-nodal DLBCL. Even so, literature is lacking on early, localised presentations. We studied a cohort of patients with stage I disease, diagnosed between 2006 and 2018, from six centres between Australia, Canada and Denmark. Our goal was to characterise outcomes, review treatment and investigate the role of interim positron emission tomography (iPET). Thirty-seven eligible patients were identified. The median duration of follow-up was 42.2 months. All received chemoimmunotherapy with 91.9% (n = 34) given rituximab, cyclophosphamide, doxorubicin, vincristine and prednisolone (R-CHOP). 35.1% (n = 13) underwent consolidative radiotherapy. Eighteen patients were H. pylori positive and 11 had the documentation of H. pylori eradication therapy. The 4-year progression-free survival and overall survival of R-CHOP was 88% (95% CI: 71-95) and 91% (95% CI: 75-97) respectively. All patients who achieved a partial metabolic response or complete metabolic response on iPET went on to achieve complete response at the end of treatment. R-CHOP-based therapy with iPET assessment appears to offer favourable outcomes, with radiotherapy and H. pylori eradication therapy implemented on a case-by-case basis.

摘要

原发性胃弥漫性大 B 细胞淋巴瘤(PG-DLBCL)占结外 DLBCL 的大多数。即便如此,对于早期局限性表现的文献仍较少。我们研究了 2006 年至 2018 年间来自澳大利亚、加拿大和丹麦的六个中心的 I 期疾病患者队列。我们的目标是描述结局、回顾治疗方法并探讨中期正电子发射断层扫描(iPET)的作用。确定了 37 名符合条件的患者。中位随访时间为 42.2 个月。所有患者均接受化疗联合免疫治疗,91.9%(n=34)接受利妥昔单抗、环磷酰胺、多柔比星、长春新碱和泼尼松(R-CHOP)。35.1%(n=13)接受巩固性放疗。18 名患者 H. pylori 阳性,11 名患者有 H. pylori 根除治疗的记录。R-CHOP 的 4 年无进展生存率和总生存率分别为 88%(95%CI:71-95)和 91%(95%CI:75-97)。所有在 iPET 上达到部分代谢缓解或完全代谢缓解的患者在治疗结束时均达到完全缓解。基于 R-CHOP 并结合 iPET 评估的治疗似乎可提供良好的结局,并根据具体情况实施放疗和 H. pylori 根除治疗。

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