• 中国科学论文统计源期刊
  • 中国科技核心期刊
  • 美国化学文摘(CA)来源期刊
  • 日本科学技术振兴机构数据库(JST)
临床输血与检验

临床输血与检验 ›› 2022, Vol. 24 ›› Issue (6): 773-776.DOI: 10.3969/j.issn.1671-2587.2022.06.018

• 临床研究 • 上一篇    下一篇

16例原发纵膈大B细胞淋巴瘤患者临床特征及预后分析

胡星, 江慧, 薛磊, 耿良权, 胡茂贵, 丁凯阳, 郑昌成, 童娟   

  1. 230001 中国科学技术大学附属第一医院(安徽省立医院)血液内科
  • 收稿日期:2022-08-02 发布日期:2023-01-05
  • 通讯作者: 童娟,女,主要从事血液系统恶性肿瘤和出凝血相关疾病方面研究,（E-mail）tongj5200@163.com。
  • 作者简介:胡星（1993-）,女,安徽阜阳人,硕士,主要从事血液系统恶性肿瘤方面研究,（E-mail）564905438@qq.com。

Clinical Characteristics and Prognosis of 16 Patients with Primary Mediastinal Large B-cell Lymphoma

HU Xing, JIANG Hui, XUE Lei, et al   

  1. Department of Hematology, First Affiliated Hospital of USTC (Anhui Provincial Hospital), HeFei, 230001
  • Received:2022-08-02 Published:2023-01-05

RichHTML

2

PDF

811

摘要： 目的 回顾性分析16例原发纵膈大B细胞淋巴瘤（PMBCL）患者的临床特征、疗效评估、疾病进展的危险因素及其生存预后。方法 回顾性分析中国科学技术大学附属第一医院（安徽省立医院）自2015年3月~2022年2月收治的16例PMBCL患者的临床资料,分析患者的临床特征及预后特点,并对相关数据进行统计分析。结果 16例PMBCL患者的中位总生存（OS）时间未达到,5年OS率为92.3%。中位无进展生存（PFS）时间为 7（95%CI 6.5~15.5）个月,5年PFS为43.3%。至随访截止日期,16例患者中,1例失访,中位随访时间 25（95%CI 4~70）个月 ,14例（93.3％）生存,其中8例持续完全缓解（CR）,5例部分缓解（PR）,总缓解率（ORR）为86.67%。4例难治复发患者,使用PD-1抑制剂ORR达75%。单因素预后分析表明Ann Arbor分期、B组症状、LDH水平、是否巨型包块、aa-IPI评分、PET-CT病灶SUV-max、Mum-1是否阳性、不同Ki-67水平均不是引起PMBCL疾病进展的危险因素。结论 PMBCL患者初始治疗使用含有利妥昔单抗的化疗方案,可改善患者总生存,但PFS改善不佳,需要新的方案以期待达到治愈的目的。复发难治PMBCL可考虑使用以PD-1单抗为基础的治疗方案。

关键词: 原发纵膈大B细胞淋巴瘤, PD-1单抗, 预后, 临床特征

Abstract: Objective To explore the clinical characteristics, efficacy evaluation, risk factors for disease progression and survival prognosis of patients with primary mediastinal large B-cell lymphoma (PMBCL). Method The clinical data of 16 patients with PMBCL from March 2015 to February 2022 in First Affiliated Hospital of USTC (Anhui Provincial Hospital) were retrospectively analyzed. The clinical characteristics and prognosis of the patients were statistically analyzed. Results The median overall survival (OS) time of 16 patients with PMBCL was not reached, and the 5-years OS rate was 92.3%. And the median progression-free survival (PFS) time was 7 (95%CI: 6.5~15.5) months, and the 5-years PFS was 43.3%. As of the follow-up date, the median follow-up time was 25 (4~70) months. One (1/16, 6.3%) patients was lost to follow-up, 14 (93.3%) patients was alive, in which 8 patients reached complete remission (CR) and 5 patients reached partial remission (PR), and the overall response rate (ORR) was 86.67%. The ORR was 75% in patients with refractory relapse PMBCL after using PD-1 inhibitor. Univariate analysis showed that Ann Arbor stage, group B symptoms, LDH level, whether there was a huge mass, aa-IPI score, whether SUV Max and mum-1 were positive in PET-CT lesions, and different Ki-67 levels were not risk factors for PMBCL disease progression. Conclusion The OS in the patients with PMBCL, who received induction chemotherapy treatment containing rituximab, has been improved. However, the PFS has not been improved well and the new regimen is needed to achieve the goal of cure in patients. The regimen containing PD-1 inhibitor can be considered for patients with relapsed and refractor PMBCL.

Key words: Primary mediastinal large B-cell Lymphoma, PD-1 inhibitor, Prognosis, Clinical characteristics

中图分类号: