Yang Man, Huang Yan, Zhu Lu-Yao, Zhang Ling-Xiu, Zi You-Mei, Wang Xiu-Feng, Zhang Yuan
Department of Hematology, The First Affiliated Hospital of Xinxiang Medical University,Xinxiang 453100, Henan Province, China.
Xinxiang Key Laboratory of Lymphoma Molecular Diagnosis and Treatment, Xinxiang 453100, Henan Province, China.E-mail:
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2024 Oct;32(5):1414-1419. doi: 10.19746/j.cnki.issn.1009-2137.2024.05.017.
To investigate the clinical efficacy of ibrutinib combined with venetoclax in the treatment of relapsed/refractory diffuse large B-cell lymphoma (R/R DLBCL), and to analyze the factors affecting efficacy and prognosis.
Clinical data of 62 R/R DLBCL patients admitted to our hospital from August 2017 to July 2022 were retrospectively analyzed. All patients were treated with ibrutinib combined with venetoclax. The clinical efficacy and drug safety were evaluated. The effects of clinical features on short-term efficacy and overall survival (OS) were analyzed.
The objective response rate (ORR) of 62 patients was 48.39%. The extranodal lesions, intermediate-high/high risk of NCCN-IPI, intermediate-high/high risk of IPI, progression or recurrence time <12 months were the risk factors affecting the short-term efficacy of chemotherapy in R/R DLBCL patients (all < 0.05). The most common adverse effect was neutropenia (75.19%), and the incidence of grade Ⅲ-Ⅳ neutropenia was 52.71%. The 1-year and 2-year OS rates of 62 patients were 48.51% and 31.56%, respectively, and the median OS time was 12 months. Multivariate analysis showed that objective remission after chemotherapy [ =0.080 (95%CI: 0.028-0.235)] was a protective factor for OS in R/R DLBCL patients, and intermediate-high/high risk of NCCN-IPI [ =4.828 (95% : 1.546-15.080)] was an independent risk factor affecting the prognosis of R/R DLBCL patients.
Ibrutinib combined with venetoclax can be used as an effective treatment regimen for R/R DLBCL, and NCCN-IPI can be used as a prognostic indicator. Objective remission after chemotherapy is beneficial for R/R DLBCL patients to achieve better OS.
探讨伊布替尼联合维奈克拉治疗复发/难治性弥漫性大B细胞淋巴瘤（R/R DLBCL）的临床疗效，并分析影响疗效和预后的因素。
回顾性分析2017年8月至2022年7月我院收治的62例R/R DLBCL患者的临床资料。所有患者均接受伊布替尼联合维奈克拉治疗。评估临床疗效和药物安全性。分析临床特征对短期疗效和总生存期（OS）的影响。
62例患者的客观缓解率（ORR）为48.39%。结外病变、NCCN-IPI中高/高危、IPI中高/高危、进展或复发时间<12个月是影响R/R DLBCL患者化疗短期疗效的危险因素（均<0.05）。最常见的不良反应是中性粒细胞减少（75.19%），Ⅲ-Ⅳ级中性粒细胞减少的发生率为52.71%。62例患者的1年和2年OS率分别为48.51%和31.56%，中位OS时间为12个月。多因素分析显示，化疗后客观缓解[=0.080（95%CI：0.028-0.235）]是R/R DLBCL患者OS的保护因素，NCCN-IPI中高/高危[=4.828（95%：1.546-15.080）]是影响R/R DLBCL患者预后的独立危险因素。
伊布替尼联合维奈克拉可作为R/R DLBCL的有效治疗方案，NCCN-IPI可作为预后指标。化疗后客观缓解有利于R/R DLBCL患者获得更好的OS。
