DeNardo G L, Lamborn K R, DeNardo S J, Goldstein D S, Dolber-Smith E G, Kroger L A, Larkin E C, Shen S
Department of Internal Medicine, University of California Davis Medical Center, Sacramento 95817, USA.
Cancer Res. 1995 Dec 1;55(23 Suppl):5893s-5898s.
The Ann Arbor staging classification has proven less useful in nonHodgkin's lymphoma, because this malignancy is inherently a multifocal disorder. Since 1985, 57 adult patients with advanced B-lymphocytic malignancies that progressed despite standard therapy entered into one of three different therapy trials using radiolabeled Lym-1 antibody. Tumor regression in 31 (54%) of these patients fulfilled conventional requirements for an oncological response to the therapy. To define the role of radioimmunotherapy in B-lymphocytic malignancies better and to find opportunities for improving its therapeutic efficacy, the records of these patients were reviewed to assess the significance of various parameters as prognostic indicators. Twenty-one pretherapy characteristics were evaluated, including age at diagnosis, age at study entry, sex, Karnofsky performance status, prior chemotherapy and radiation therapy, interval since diagnosis, histology, constitutional B symptoms, extranodal malignancy (excluding marrow), bone marrow malignancy, tumor bulk, and circulating malignant cells; blood tests included lymphocyte, granulocyte, platelet, hematocrit, serum lactate dehydrogenase (LDH), interleukin 2 receptor, and human antimouse antibody levels. In the multivariate analysis, LDH and Karnofsky performance status were the parameters that best predicted survival, complete and partial remission, and time to progression; interleukin 2 receptor and LDH best predicted complete remission. These prognostic factors for radioimmunotherapy outcome are consistent with the pretherapy characteristics observed to be significant for chemotherapy.
安阿伯分期分类法在非霍奇金淋巴瘤中已被证明实用性较差，因为这种恶性肿瘤本质上是一种多灶性疾病。自1985年以来，57例成年晚期B淋巴细胞恶性肿瘤患者，尽管接受了标准治疗仍病情进展，他们参加了三项不同的使用放射性标记Lym-1抗体的治疗试验中的一项。这些患者中有31例（54%）出现肿瘤消退，符合对该治疗的肿瘤学反应的传统要求。为了更好地确定放射免疫疗法在B淋巴细胞恶性肿瘤中的作用，并寻找提高其治疗效果的机会，对这些患者的记录进行了回顾，以评估各种参数作为预后指标的意义。评估了21项治疗前特征，包括诊断时年龄、入组研究时年龄、性别、卡氏功能状态、既往化疗和放疗情况、诊断后的间隔时间、组织学类型、全身B症状、结外恶性肿瘤（不包括骨髓）、骨髓恶性肿瘤、肿瘤体积和循环恶性细胞；血液检查包括淋巴细胞、粒细胞、血小板、血细胞比容、血清乳酸脱氢酶（LDH）、白细胞介素2受体和人抗鼠抗体水平。在多变量分析中，LDH和卡氏功能状态是最能预测生存、完全缓解和部分缓解以及进展时间的参数；白细胞介素2受体和LDH最能预测完全缓解。这些放射免疫疗法结果的预后因素与观察到的对化疗有显著意义的治疗前特征一致。
