Extranodal involvement in young patients with diffuse large B-cell lymphoma: distribution, prognostic value and treatment options.
Extranodal involvement in young patients with diffuse large B-cell lymphoma: distribution, prognostic value and treatment options.
复制标题
年轻弥漫性大 B 细胞淋巴瘤患者的结外受累：分布、预后价值和治疗选择
DOI：
10.21147/j.issn.1000-9604.2017.01.07
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发表时间：
2017-02
期刊：
影响因子：
--
通讯作者：
Liu Y
中科院分区：
文献类型：
--
作者：
Yao S;Li J;Yao Z;Xu Y;Chu J;Zhang J;Jin S;Huang Y;Zhang J;Ma J;Zhao Y;Yang S;Liu Y
目的结外受累是弥漫性大B细胞淋巴瘤（DLBCL）的一种特殊表现。以前的研究表明，老年患者更容易发生结节性病变。本研究回顾性讨论了年轻DLBCL患者结外受累的分布、预后价值和治疗选择。方法按纳入标准纳入329例患者。评估了性别、结节受累、年龄调整的国际预后指数（aaIPI）、利妥昔单抗输注和放疗对患者预后的影响。结果59%的患者累及16个解剖部位。与淋巴结疾病或单一病例相比，多个病例与许多较差的临床特征和较差的生存率相关。多变量分析显示，在一个结节病变的患者中，结节受累的部位与预后独立相关，而不是aaIPI或利妥昔单抗输注，放疗对生存率有负面影响。结论结外侵犯在年轻患者中很常见，并且表现出普遍的分布。结直肠受累的部位对预后有重要意义。结节性病变的放射治疗不能改善患者的预后。
Objective Extranodal involvement represents a peculiar presentation of diffuse large B-cell lymphoma (DLBCL). Previous studies have suggested that older patients are more prone to extranodal involvement. This study retrospectively addressed the distribution, prognostic value and treatment options of extranodal involvement in young patients with DLBCL. Methods A total of 329 patients were enrolled according to the inclusion requirements. The effects of gender, extranodal involvement, age-adjusted international prognostic index (aaIPI), rituximab infusion and radiotherapy on patient outcomes were evaluated. Results Among these patients, 59% presented extranodal involvement in 16 anatomic sites. More than one instance was linked to many poorer clinical characteristics and poorer survival compared with either nodal disease or one instance. In patients with one extranodal lesion, multivariate analysis revealed that the site of extranodal involvement, but not the aaIPI or rituximab infusion, was independently related to the outcome, and radiotherapy had a negative influence on survival. Conclusions Extranodal involvement is common in younger patients and exhibits a ubiquitous distribution. The site of extranodal involvement is of strong prognostic significance. Radiotherapy for extranodal lesions does not improve patient outcomes.