R-CHOP方案治疗双表达弥漫大B细胞淋巴瘤有效性真实世界研究*

doi:10.3969/j.issn.1671-2587.2023.04.020

临床输血与检验 ›› 2023, Vol. 25 ›› Issue (4): 533-538.DOI: 10.3969/j.issn.1671-2587.2023.04.020

R-CHOP方案治疗双表达弥漫大B细胞淋巴瘤有效性真实世界研究^*

赵彬, 陶千山, 沈元元, 董毅

安徽医科大学第二附属医院血液科,安徽合肥 230601

收稿日期:2023-04-17 出版日期:2023-08-20 发布日期:2023-09-18
通讯作者: 董毅,主任医师,主要从事淋巴瘤方面研究,（E-mail）dongyixx@126.com。
作者简介:赵彬,主要从事淋巴瘤方面研究,（E-mail）3180828231@qq.com。
基金资助:
*本课题受安徽省科技计划项目（No.12010402c195）、白求恩医学科学研究基金（No.B19064ET）资助

Real-world Study of the Effectiveness of the R-CHOP Regimen in Treating Double-expressing Diffuse Large B-cell Lymphoma

ZHAO Bin, TAO Qianshan, SHEN Yuanyuan, et al

Department of Hematology, The Second Affiliated Hospital of Anhui Medical University, Hefei 230601

Received:2023-04-17 Online:2023-08-20 Published:2023-09-18

摘要/Abstract

摘要： 目的分析R-CHOP方案治疗MYC和Bcl-2双表达弥漫大B细胞淋巴瘤（DEL）的有效性。方法回顾性分析2017年12月—2022年12月安徽医科大学第二附属医院收治的DEL患者临床资料,选择同期入院的non-DEL患者作为对照组,分析患者的临床特征、生存和预后因素。结果共收集DLBCL患者243例,其中DEL患者63例（25.9％）,DEL患者与non-DEL患者的临床特征未见明显差异,DEL患者的完全缓解率（CR）明显低于non-DEL患者（P=0.033）。而non-DEL组及DEL组3年的无进展生存（PFS）分别为74.5％与41.7％,中位PFS分别为38.6个月（95％CI：33.3~43.9）与30.2个月（95％CI：22.3~38.2）（P=0.003）,3年的总生存（OS）分别为80.3％与60.4％,中位OS分别为49.2个月（95％CI：44.6-53.8）与34.2个月（95％CI：28.1~40.4）（P=0.031）,差异有统计学意义。对DEL患者进行多因素Cox回归分析,显示只有IPI评分影响PFS（HR=51.695,P=0.001）及OS（HR=6.513,P=0.001）。结论 DEL患者与non-DEL患者临床特征无显著差异,使用R-CHOP方案一线治疗的DEL患者预后不良,具有较差的PFS及OS。

关键词: 弥漫大B细胞淋巴瘤, 临床特征, 有效性, 双表达

Abstract: Objective To analyze the effectiveness of the R-CHOP regimen in the treatment of double-expression diffuse large B-cell lymphoma (DEL). Methods A retrospective analysis of the clinical data of the DEL patients admitted to the Second Affiliated Hospital of Anhui Medical University from December 2017 to December 2022. The clinical characteristics, survival and prognostic factors were analyzed, and non-DEL patients admitted in the same period were selected as the control group. Results A total of 243 DLBCL patients were collected, including 63 cases of DEL patients (25.9%). There were no differences in the clinical characteristics between DEL patients and non-DEL patients. The complete remission (CR) rate of DEL patients was significantly lower than that of non-DEL patients (P=0.033).The non-DEL and DEL groups had a progression-free (PFS) rate of 74.5% and 41.7% respectively at 3 years, with median PFS was 38.6 (95％CI:33.3~43.9)month and 30.2 (95％CI:22.3~38.2) month (P=0.003). The overall survival (OS) rate at 3 years was 80.3% in the non-DEL group and 60.4% in the DEL group, with median OS of 49.2(95％CI:44.6~53.8) month and 34.2 (95％CI:28.1~40.4) month respectively (P=0.031), the difference were statistically significant. Multivariate COX regression analysis of DEL patients showed that only the IPI score affected the PFS (HR=51.695, P=0.001) and OS (HR=6.513, P=0.001). Conclusion There is no significant difference between DEL and non-DEL patients in clinical characteristics. DEL patients undergoing first-line treatment with R-CHOP regimen have poor prognosis.

Key words: Diffuse with large, B-cell lymphoma, Clinical features, Effectiveness, Double expression

中图分类号:

R551.2

赵彬, 陶千山, 沈元元, 董毅. R-CHOP方案治疗双表达弥漫大B细胞淋巴瘤有效性真实世界研究^*[J]. 临床输血与检验, 2023, 25(4): 533-538.

ZHAO Bin, TAO Qianshan, SHEN Yuanyuan, et al. Real-world Study of the Effectiveness of the R-CHOP Regimen in Treating Double-expressing Diffuse Large B-cell Lymphoma[J]. JOURNAL OF CLINICAL TRANSFUSION AND LABORATORY MEDICINE, 2023, 25(4): 533-538.

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R-CHOP方案治疗双表达弥漫大B细胞淋巴瘤有效性真实世界研究^*

Real-world Study of the Effectiveness of the R-CHOP Regimen in Treating Double-expressing Diffuse Large B-cell Lymphoma

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