Clinicopathological risk factors for a poor prognosis of primary central nervous system lymphoma in elderly patients in the Tohoku and Niigata area: a multicenter, retrospective, cohort study of the Tohoku Brain Tumor Study Group
Clinicopathological risk factors for a poor prognosis of primary central nervous system lymphoma in elderly patients in the Tohoku and Niigata area: a multicenter, retrospective, cohort study of the Tohoku Brain Tumor Study Group
复制标题
DOI：
10.1007/s10014-022-00427-4
复制
发表时间：
2022-03-21
影响因子：
3.3
通讯作者：
Tominaga, Teiji
中科院分区：
文献类型：
--
作者：
Asano, Kenichiro;Yamashita, Yoji;Tominaga, Teiji
对老年中枢神经系统恶性淋巴瘤患者预后不良的临床病理危险因素进行了研究。回顾性分析了日本东北和新泻地区共82例71岁或以上经病理证实的CD 20阳性弥漫性大B细胞淋巴瘤患者，这些患者接受了治疗干预。使用Kaplan-Meier方法通过对数秩检验进行单变量分析。采用考克斯比例风险模型对危险因素进行多因素分析。在82例患者中，39例为男性，43例为女性，发病时的中位年龄为75岁。研究结束时，有34例无复发患者（41.5%），48例复发病例（58.5%），中位无进展生存期为18个月，中位总生存期（OS）为26个月;有41例死亡，41例存活。中位OS的多变量分析显示，治疗后3个月Karnofsky体力状态低于60（p = 0.022，风险比（HR）= 2.591）是临床风险因素，双表达淋巴瘤（p = 0.004，HR = 3.163），肿瘤浸润淋巴细胞或肿瘤相关巨噬细胞中程序性死亡配体1的表达EB病毒感染（p = 0.031，HR = 5.304）是病理危险因素。
Clinicopathological risk factors for a poor prognosis were investigated in elderly patients with malignant lymphoma of the central nervous system. A total of 82 pathologically confirmed, CD20-positive, diffuse large B-cell lymphoma patients aged 71 years or older who underwent therapeutic intervention in the Tohoku and Niigata area in Japan were retrospectively reviewed. A univariate analysis was performed by the log-rank test using the Kaplan-Meier method. A Cox proportional hazards model was used for multivariate analysis of risk factors. Of the 82 patients, 39 were male and 43 were female, and their median age at onset was 75 years. At the end of the study, there were 34 relapse-free patients (41.5%), 48 relapse cases (58.5%), median progression-free survival was 18 months, and median overall survival (OS) was 26 months; there were 41 deaths and 41 survivors. Multivariate analysis of median OS showed that Karnofsky Performance Status less than 60% 3 months after treatment (p = 0.022, hazard ratio (HR) = 2.591) was the clinical risk factor, and double expressor lymphoma (p = 0 .004 , HR = 3.163), expression of programmed death-ligand 1 in tumor infiltrating lymphocytes or tumor-associated macrophages (p < 0.001, HR= 5.455), and Epstein-Barr virus infection (p = 0.031, HR = 5.304) were the pathological risk factors.