Chen Xiao-Jun, Lin Su-Xia, Gan Dong-Hui, Shen Jian-Zhen, Fu Yu-Min, Yin Yue, Zeng Min-Juan, Liu Yan-Quan
Department of Hematology and Rheumatology, The Affiliated Hospital of Putian University, Putian 351100, Fujian Province, China.
Department of Hematology, Fujian Medical University Union Hospital, Fuzhou 350001, Fujian Province, China.
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2024 Aug;32(4):1097-1105. doi: 10.19746/j.cnki.issn.1009-2137.2024.04.019.
To explore and analyze the clinical features and prognostic factors of secondary intestinal diffuse large B-cell lymphoma (SI-DLBCL), in order to provide reference for the basic research and clinical diagnosis and treatment of secondary lymphoma of rare sites in the field of hematology.
The clinical data of 138 patients with SI-DLBCL admitted to Fujian Medical University Union Hospital from June 2011 to June 2022 were collected and sorted, the clinical and pathological features, diagnosis, treatment and prognosis were analyzed. Cox regression risk model was used to conduct univariate and multivariate analysis on the prognostic risk factors.
Among the 138 patients with SI-DLBCL included in this study, 85 (61.59%) were male, 53 (38.41%) were female, the median age of onset was 59.5 (16-84) years, the clinical manifestations lacked specificity, the first-line treatment regimen was mainly chemotherapy (67.39%), 94 cases (68.12%) received chemotherapy alone, 40 cases (28.98%) were treated with chemotherapy combined with surgery, and 4 cases (2.90%) were treated with surgery alone. The median follow-up time was 72 (1-148) months. Among the 138 patients with SI-DLBCL, 79 (57.25%) survived, 34 (24.64%) died, 25 cases (18.12%) lost to follow-up, the PFS rates of 1-year, 3-year and 5-year were 57.97%, 49.28% and 32.61%, and the OS rates of 1-year, 3-year and 5-year were 60.14%, 54.35% and 34.06%, respectively. The results of univariate Cox regression analysis showed that age, Lugano stage and IPI score were the influencing factors of OS in SI-DLBCL patients, and age, Lugano stage and IPI score were the influencing factors of PFS in SI-DLBCL patients. The results of multivariate Cox analysis showed that Lugano stage was an independent prognostic factor affecting OS and PFS in SI-DLBCL patients.
Patients with SI-DLBCL are more common in middle-aged and elderly men, and the early clinical manifestations lack specificity, and the first-line treatment regimen is mainly R-CHOP chemotherapy, and Lugano stage is an independent prognostic factor affecting OS and PFS in SI-DLBCL patients.
探讨和分析继发性肠道弥漫性大B细胞淋巴瘤(SI-DLBCL)的临床特征及预后因素,为血液学领域罕见部位继发性淋巴瘤的基础研究及临床诊治提供参考。
收集并整理2011年6月至2022年6月福建医科大学附属协和医院收治的138例SI-DLBCL患者的临床资料,分析其临床病理特征、诊断、治疗及预后情况。采用Cox回归风险模型对预后危险因素进行单因素和多因素分析。
本研究纳入的138例SI-DLBCL患者中,男性85例(61.59%),女性53例(38.41%),发病年龄中位数为59.5(16 - 84)岁,临床表现缺乏特异性,一线治疗方案主要为化疗(67.39%),94例(68.12%)单纯接受化疗,40例(28.98%)接受化疗联合手术治疗,4例(2.90%)单纯接受手术治疗。中位随访时间为72(1 - 148)个月。138例SI-DLBCL患者中,79例(57.25%)存活,34例(24.64%)死亡,25例(18.12%)失访;1年、3年和5年的无进展生存率分别为57.97%、49.28%和32.61%,1年、3年和5年的总生存率分别为60.14%、54.35%和34.06%。单因素Cox回归分析结果显示,年龄、卢加诺分期和国际预后指数(IPI)评分是SI-DLBCL患者总生存的影响因素,年龄、卢加诺分期和IPI评分是SI-DLBCL患者无进展生存的影响因素。多因素Cox分析结果显示,卢加诺分期是影响SI-DLBCL患者总生存和无进展生存的独立预后因素。
SI-DLBCL患者以中老年男性多见,早期临床表现缺乏特异性,一线治疗方案主要为R-CHOP化疗,卢加诺分期是影响SI-DLBCL患者总生存和无进展生存的独立预后因素。