Yang P, Luo L, Liu S Z, Li C Y, Chen Y T, Zhang W, Liu H, Xiao X B, Jing H M
Peking University Third Hospital, Beijing 100191, China.
Peking Union Medical College Hospital, Beijing 100730, China.
Zhonghua Xue Ye Xue Za Zhi. 2024 Jul 14;45(7):660-665. doi: 10.3760/cma.j.cn121090-20240118-00032.
This study aims to explore the survival advantages of different maintenance strategies for MCL. Clinical data of 693 newly diagnosed MCL patients in multi-centers admitted from April 1999 to December 2019 were collected. 309 cases received maintenance treatment. The characteristics of patients in different maintenance treatment groups were summarized and Kaplan-Meier survival and prognosis analysis were conducted. The overall 3-year and 5-year progression-free survival (PFS) rates were (73.5±2.9) % and (53.6±4.3) %, respectively. The 3-year and 5-year overall survival (OS) rates were (94.2±1.5) % and (82.7±3.2) %, respectively. The clinical features of different maintenance treatment groups were generally consistent. The 3-year PFS rates of rituximab maintenance, lenalidomide maintenance, BTK inhibitor maintenance and dual-drug maintenance were (70.4±4.1) %, (69.1±7.6) %, (86.9±5.0) %, and (80.4±5.1) %, respectively. Corresponding 3-year OS rates were (92.9±2.4) %, (97.3±2.7) %, (97.9±2.1) %, and (95.3±2.7) %, respectively. There were no significant difference in different groups (=0.632, 0.313). Survival analysis identified the MCL International Prognostic Index (MIPI) high-risk group and achieving complete remission before maintenance treatment as independent risk factors for PFS. The MIPI high-risk group, high-dose cytarabine application, treatment lines, and early disease progression (POD24) emerged as independent risk factors for OS. Comparing the different maintenance strategies of MCL, the result showed that BTK inhibitors (BTKi) maintenance demonstrated preliminary advantages in survival. Meanwhile, high-risk group according to MIPI and incomplete remission before maintenance treatment were significant factors related to disease progression.
本研究旨在探讨套细胞淋巴瘤(MCL)不同维持治疗策略的生存优势。收集了1999年4月至2019年12月期间多中心收治的693例新诊断MCL患者的临床资料。309例患者接受了维持治疗。总结了不同维持治疗组患者的特征,并进行了Kaplan-Meier生存和预后分析。总体3年和5年无进展生存率(PFS)分别为(73.5±2.9)%和(53.6±4.3)%。3年和5年总生存率(OS)分别为(94.2±1.5)%和(82.7±3.2)%。不同维持治疗组的临床特征总体一致。利妥昔单抗维持治疗、来那度胺维持治疗、布鲁顿酪氨酸激酶(BTK)抑制剂维持治疗和双药维持治疗的3年PFS率分别为(70.4±4.1)%、(69.1±7.6)%、(86.9±5.0)%和(80.4±5.1)%。相应的3年OS率分别为(92.9±2.4)%、(97.3±2.7)%、(97.9±2.1)%和(95.3±2.7)%。不同组间无显著差异(P=0.632,0.313)。生存分析确定MCL国际预后指数(MIPI)高危组和维持治疗前达到完全缓解是PFS的独立危险因素。MIPI高危组、大剂量阿糖胞苷应用、治疗线数和早期疾病进展(POD24)是OS的独立危险因素。比较MCL的不同维持治疗策略,结果显示BTK抑制剂(BTKi)维持治疗在生存方面显示出初步优势。同时,根据MIPI的高危组和维持治疗前未完全缓解是与疾病进展相关的重要因素。