The international staging system improves the IPI risk stratification in patients with diffuse large B-cell lymphoma treated with R-CHOP.
The international staging system improves the IPI risk stratification in patients with diffuse large B-cell lymphoma treated with R-CHOP.
复制标题
国际分期系统改善了接受 R-CHOP 治疗的弥漫性大 B 细胞淋巴瘤患者的 IPI 风险分层
DOI：
10.1038/s41598-017-13254-x
复制
发表时间：
2017-10-19
影响因子：
4.6
通讯作者：
Wei Y
中科院分区：
文献类型：
--
作者：
Wei X;Hao X;Zhou L;Wei Q;Zhang Y;Huang W;Song J;Feng R;Wei Y
基于血清β 2微球蛋白和白蛋白的国际分期系统（ISS）用于预测多发性骨髓瘤的生存率，但其在弥漫性大B细胞淋巴瘤（DLBCL）中的预后意义尚不清楚。在此，我们回顾性分析了215例原发DLBCL患者。根据ISS，215例患者中有90例（41.9%）为I期，98例（45.6%）为II期，27例（12.6%）为III期。ISS II/III期患者的总生存期（OS）和无事件生存期（EFS）均短于接受R-CHOP方案治疗的I期患者（分别为p = 0.012和p = 0.043），但与接受CHOP方案治疗的患者相比，差异无统计学意义（p > 0.05）。多变量分析显示，ISS（独立于IPI）表明接受R-CHOP治疗的DLBCL患者的OS（HR，5.690; 95% CI，1.270-25.495，p = 0.023）和EFS（HR，2.116; 95% CI，1.005-4.455，p = 0.049）生存率不同。ISS可以识别中-高/高IPI风险患者中具有更好结局的患者（p < 0.05）。我们的数据表明，晚期ISS分期与接受R-CHOP治疗的DLBCL患者的不良结局相关。ISS可以从高IPI风险患者中识别出具有上级结局的DLBCL患者亚组，这可能有助于避免强化治疗。
The international staging system (ISS), based on serum beta-2 microglobulin and albumin, is used to predict survival in multiple myeloma, but its prognostic significance in diffuse large B-cell lymphoma (DLBCL) remains unknown. Herein, we retrospectively analyzed 215 de novo DLBCL patients. According to ISS, there were 90 of 215 (41.9%) patients in stage I, 98 of 215 (45.6%) in stage II and 27 of 215 (12.6%) in stage III group. Patients with ISS stage II/III showed shorter overall survival (OS) and event free survival (EFS) than those with stage I treated with R-CHOP (p = 0.012 and p = 0.043, respectively), but not those treated with CHOP regimen (p > 0.05). Multivariable analysis revealed that ISS, independent of IPI, indicated different survival in both OS (HR, 5.690; 95% CI, 1.270–25.495, p = 0.023) and EFS (HR, 2.116; 95% CI, 1.005–4.455, p = 0.049) in DLBCL patients treated with R-CHOP. ISS could identify patients with better outcome in intermediate-high/high IPI risk patients (p < 0.05). Our data suggests that advanced ISS stage is associated with inferior outcome in DLBCL patients treated with R-CHOP. ISS could identify a subgroup of DLBCL patients with superior outcome from high IPI risk patients, which may help to avoid intensive therapy.
登录
查看更多内容
影响因子：
--
作者：
Töpfer K;Kempe S;Müller N;Schmitz M;Bachmann M;Cartellieri M;Schackert G;Temme A
通讯作者：
Temme A
影响因子：
2.7
作者：
Bataille, Regis;Annweiler, Cedric;Beauchet, Olivier
通讯作者：
Beauchet, Olivier
影响因子：
2.7
作者：
Miyashita, Kazuho;Tomita, Naoto;Ishigatsubo, Yoshiaki
通讯作者：
Ishigatsubo, Yoshiaki
影响因子：
2.1
作者：
Zhou, Qinjun;Wei, Yongqiang;Feng, Ru
通讯作者：
Feng, Ru
影响因子：
51.1
作者：
Pfreundschuh, Michael;Trumper, Lorenz;Loeffler, Markus
通讯作者：
Loeffler, Markus