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[简化综合老年评估系统在老年弥漫性大B细胞淋巴瘤患者中的多中心回顾性临床研究]

[A multicenter retrospective clinical study of a simplified comprehensive geriatric assessment system in elderly patients with diffuse large B-cell lymphoma].

作者信息

Leng J Y, Cai Y H, Ge X P, Zhao N P, Su Q Q, Jia Z X, Qian J, Li B Z, Hua H Y, Lu X Z, Zhu H Y, Li J Y, Shi W Y

机构信息

Department of Hematology, Affiliated People's Hospital of Jiangsu University, Zhenjiang 212002, China Department of Hematology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.

Department of Oncology, Affiliated Hospital of Nantong University, Nantong 226001, China.

出版信息

Zhonghua Xue Ye Xue Za Zhi. 2025 Feb 14;46(2):126-133. doi: 10.3760/cma.j.cn121090-20241121-00467.

Abstract

To evaluate the predictive value of simplified geriatric assessment (sGA) in elderly Chinese patients diagnosed with diffuse large B-cell lymphoma (DLBCL) . It retrospectively analyzed the relationships of sGA with the clinical characteristics, outcome, and prognosis of 219 patients aged ≥60 years who were newly diagnosed with DLBCL at six hospitals in Jiangsu province between January 2018 and December 2022. The median age of 219 patients was 68 years (60-87 years). According to the sGA system criteria, 101 (46.1%), 103 (47.0%), and 15 (6.8%) elderly patients with DLBCL were categorized as fit, unfit, and frail, respectively. The most common adverse reactions after chemotherapy were hematologic, and the incidence of grade >2 hematologic adverse reactions was similar among the three groups (47.5% 41.7% 46.7%, respectively; (2)=0.712, =0.700). Compared with the fit and unfit groups, the frail group showed tendencies toward for higher proportions of grade >2 gastrointestinal, pulmonary, and infectious adverse reactions (>0.05 for all). The fit, unfit, and frail groups had respective remission rates of 74.3%, 46.6%, and 20.0% ((2)=25.249, <0.001) ; disease progression rates of 5.9%, 11.7%, and 26.7% ((2)=6.763, <0.05) ; 2-year overall survival rates of 92.1% (95% 86.6% to 97.9%), 77.6% (95% 69.5% to 86.6%), and 70.1% (95% 49.4% to 99.6%) (<0.05) ; and 2-year progression-free survival rates of 76.8% (95% 67.0% to 84.8%), 69.7% (95% 61.8% to 82.0%), and 65.7% (95% 53.3% to 100%) (=0.399) . sGA can effectively predict treatment adverse effects and efficacy, disease progression, and long-term survival in elderly DLBCL.

摘要

评估简化老年综合评估(sGA)对中国老年弥漫性大B细胞淋巴瘤(DLBCL)患者的预测价值。回顾性分析2018年1月至2022年12月期间江苏省六家医院新诊断为DLBCL的219例年龄≥60岁患者的sGA与临床特征、结局及预后的关系。219例患者的中位年龄为68岁(60 - 87岁)。根据sGA系统标准,101例(46.1%)、103例(47.0%)和15例(6.8%)老年DLBCL患者分别被归类为适合、不适合和虚弱。化疗后最常见的不良反应是血液学不良反应,三组中>2级血液学不良反应的发生率相似(分别为47.5%、41.7%、46.7%;(2)=0.712,=0.700)。与适合和不适合组相比,虚弱组>2级胃肠道、肺部和感染性不良反应的比例有升高趋势(均P>0.05)。适合、不适合和虚弱组的缓解率分别为74.3%、46.6%和20.0%((2)=25.249,P<0.001);疾病进展率分别为5.9%、11.7%和26.7%((2)=6.763,P<0.05);2年总生存率分别为92.1%(95%CI 86.6%至97.9%)、77.6%(95%CI 69.5%至86.6%)和70.1%(95%CI 49.4%至99.6%)(P<0.05);2年无进展生存率分别为76.8%(95%CI 67.0%至84.8%)、69.7%(95%CI 61.8%至82.0%)和65.7%(95%CI 53.3%至100%)(P=0.399)。sGA可有效预测老年DLBCL患者的治疗不良反应和疗效、疾病进展及长期生存情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7ce1/11951222/04764c44e465/cjh-46-02-126-g001.jpg

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