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霍奇金淋巴瘤患者开始治疗时间及首个周期间期延迟的影响

Impact of Time-to-Treatment Initiation and First Inter-Cycle Delay in Patients with Hodgkin Lymphoma.

作者信息

Donmez Deniz, Evlendi Yasemin, Sahin Taha Koray, Barista Ibrahim, Akin Serkan

机构信息

Department of Internal Medicine, Faculty of Medicine, Hacettepe University, Sihhiye, Ankara 06230, Turkey.

Division of Medical Oncology, Cancer Institute, Hacettepe University, Sihhiye, Ankara 06230, Turkey.

出版信息

J Clin Med. 2025 Jun 10;14(12):4085. doi: 10.3390/jcm14124085.

Abstract

: Delays in treatments are frequent in real-world lymphoma management. This study evaluates the impact of diagnosis-to-treatment intervals (DTIs) and first inter-cycle delay (IcD) on outcomes in patients with Hodgkin lymphoma (HL) receiving ABVD chemotherapy. : We retrospectively analyzed 137 patients with classical HL treated with ABVD at a single institution between 2015 and 2022. : The median age was 34 years (range: 18-73), and 62% were male. The median DTI was 14 days, with 24.1% of patients experiencing a delay of >7 days between the first and second chemotherapy cycles. The most frequent reason for delay was neutropenia, observed in 69% of delayed cases. Neither DTI nor IcD was significantly associated with PFS or OS. Multivariate analysis identified elevated beta-2 microglobulin as an independent predictor of both inferior PFS and OS. : This is the first study to evaluate both DTI and first IcD as independent prognostic factors in HL. Modest delays in treatment initiation or early cycle administration did not negatively affect survival. Timely but flexible scheduling of ABVD may be appropriate in HL. Prospective studies are warranted in the era of novel therapeutic agents.

摘要

在现实世界的淋巴瘤管理中,治疗延迟很常见。本研究评估了诊断至治疗间隔(DTI)和首次周期间延迟(IcD)对接受ABVD化疗的霍奇金淋巴瘤(HL)患者预后的影响。我们回顾性分析了2015年至2022年期间在单一机构接受ABVD治疗的137例经典HL患者。中位年龄为34岁(范围:18 - 73岁),62%为男性。中位DTI为14天,24.1%的患者在第一个和第二个化疗周期之间出现>7天的延迟。最常见的延迟原因是中性粒细胞减少,在69%的延迟病例中观察到。DTI和IcD均与无进展生存期(PFS)或总生存期(OS)无显著相关性。多变量分析确定β2微球蛋白升高是PFS和OS较差的独立预测因素。这是第一项评估DTI和首次IcD作为HL独立预后因素的研究。治疗开始或早期周期给药的适度延迟并未对生存产生负面影响。在HL中,ABVD的及时但灵活的安排可能是合适的。在新型治疗药物时代,有必要进行前瞻性研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6b40/12194712/ca6cec0a5929/jcm-14-04085-g001.jpg

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