Chen Xi, Xie Li, Zhu JunMin, Liang Lijie, Zou Bingwen, Zou Liqun
Department of Radiotherapy, Cancer Center, West China Hospital of Sichuan University, Chengdu, China.
Department of Head and Neck Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, China.
Ther Adv Hematol. 2024 Oct 28;15:20406207241292446. doi: 10.1177/20406207241292446. eCollection 2024.
Approximately 20%-30% of diffuse large B-cell lymphoma (DLBCL) cases are classified as double-expressor lymphoma (DEL), characterized by the co-expression of the MYC and BCL2 proteins. However, the most effective therapeutic strategy for DEL remains unidentified.
To evaluate the efficacy of a novel histone deacetylase inhibitor, chidamide, in combination with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (CR-CHOP) in the treatment of DEL.
This was a retrospective study.
This study included 62 DEL patients from December 2016 to December 2020. All patients were administered a first-line treatment with CR-CHOP. The short-term efficacy, survival status, and adverse reactions in this population were observed, and the prognostic factors were analyzed.
The median age was 53.9 years (range, 19-77). All patients received a median of six cycles (range, 1-8) of treatment, with 79.0% achieving complete response (CR) and an overall response rate of 88.7%. With a median follow-up of 45.5 months (range, 1-82), the median progression-free survival (PFS) and median overall survival (OS) had not yet been reached. However, the 3-year PFS rate was 71% (95% CI: 61-83), the 3-year OS rate was 87% (95% CI: 79-96), the 5-year PFS rate was 67% (95% CI: 55-80), and the 5-year OS rate was 85% (95% CI: 77-95). Age and autologous stem cell transplantation after CR or partial response were independent prognostic factors for PFS, while various clinical factors were not associated with OS outcomes. The most common grades 3-4 hematologic and nonhematologic toxicity were leukopenia (46.7%) and infection (21%), respectively.
This long-term follow-up study indicates that CR-CHOP in untreated DLBCL with the DEL phenotype demonstrates high short-term efficacy and safety as well as promising survival outcomes.
约20%-30%的弥漫性大B细胞淋巴瘤（DLBCL）病例被归类为双表达淋巴瘤（DEL），其特征为MYC和BCL2蛋白共表达。然而，DEL最有效的治疗策略仍未明确。
评估新型组蛋白去乙酰化酶抑制剂西达本胺联合利妥昔单抗、环磷酰胺、多柔比星、长春新碱和泼尼松（CR-CHOP）治疗DEL的疗效。
这是一项回顾性研究。
本研究纳入了2016年12月至2020年12月期间的62例DEL患者。所有患者均接受CR-CHOP一线治疗。观察该人群的短期疗效、生存状况和不良反应，并分析预后因素。
中位年龄为53.9岁（范围19-77岁）。所有患者接受的治疗周期中位数为6个周期（范围1-8个周期），79.0%达到完全缓解（CR），总缓解率为88.7%。中位随访45.5个月（范围1-82个月），中位无进展生存期（PFS）和中位总生存期（OS）尚未达到。然而，3年PFS率为71%（95%CI：61-83），3年OS率为87%（95%CI：79-96），5年PFS率为67%（95%CI：55-80），5年OS率为85%（95%CI：77-95）。年龄以及CR或部分缓解后的自体干细胞移植是PFS的独立预后因素，而各种临床因素与OS结局无关。最常见的3-4级血液学和非血液学毒性分别为白细胞减少（占46.7%）和感染（占21%）。
这项长期随访研究表明，CR-CHOP方案治疗具有DEL表型的初治DLBCL显示出较高的短期疗效和安全性以及良好的生存结局。
