Early event status informs subsequent outcome in newly diagnosed follicular lymphoma.
Early event status informs subsequent outcome in newly diagnosed follicular lymphoma.
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DOI：
10.1002/ajh.24492
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发表时间：
2016-11
影响因子：
12.8
通讯作者：
Link, Brian K.
中科院分区：
文献类型：
--
作者：
Maurer, Matthew J.;Bachy, Emmanuel;Ghesquieres, Herve;Ansell, Stephen M.;Nowakowski, Grzegorz S.;Thompson, Carrie A.;Inwards, David J.;Allmer, Cristine;Chassagne-Clement, Catherine;Nicolas-Virelizier, Emmanuelle;Sebban, Catherine;Lebras, Laure;Sarkozy, Clementine;Macon, William R.;Feldman, Andrew L.;Syrbu, Sergei I.;Traverse-Glehan, Alexandra;Coiffier, Bertrand;Slager, Susan L.;Weiner, George J.;Witzig, Thomas E.;Habermann, Thomas M.;Salles, Gilles;Cerhan, James R.;Link, Brian K.
滤泡性淋巴瘤（FL）的最新进展导致总生存期（OS）延长。在此评估了早期事件（定义为自诊断后12个月和24个月的无事件生存期（EFS）（EFS 12/EFS 24））是否可以告知FL中的后续OS。对2002-2012年在爱荷华州大学/马约诊所淋巴瘤SPORE分子流行病学资源（MER）中招募的920例新诊断的1-3a级FL患者进行了初步评价。EFS定义为从诊断到疾病进展、复发、再治疗或任何原因导致的死亡的时间。使用标准化死亡率比（SMR）和95%置信区间（CI），将OS与一般美国人群的年龄和性别匹配生存期进行比较。我们使用了来自法国里昂两家医院登记处的412例FL患者进行独立重复研究。未能达到EFS 12的患者的后续OS较差（MER SMR=3.72，95%CI：2.78-4.88;里昂SMR=8.74，95%CI：5.41-13.36）。相反，达到EFS 12的患者的死亡率没有超过背景人群（MER SMR=0.73，95%CI：0.56-0.94，里昂SMR=1.02，95%CI：0.58-1.65）。免疫化疗后发生早期事件的患者结局尤其差（EFS 12失败：MER SMR=17.63，95%CI：11.97-25.02，里昂SMR=19.10，95%CI：9.86-33.36; EFS 24失败：MER SMR=13.02，95%CI：9.31-17.74，里昂SMR=7.22，95%CI：4.13-11.74）。在来自两个队列的所有患者的组合数据集中，基线FLIPI在EFS 12成功者中不再提供信息。滤泡性淋巴瘤患者在诊断后12个月或免疫化疗患者在24个月时重新评估患者状态，是FL后续总生存率的强有力预测因素。早期事件状态为评估FL结局的研究提供了一个简单的、临床相关的终点。
Recent advances in follicular lymphoma (FL) have resulted in prolongation of overall survival (OS). Here assessed if early events as defined by event-free survival (EFS) at 12 and 24 months from diagnosis (EFS12/EFS24) can inform subsequent OS in FL. 920 newly diagnosed grade 1–3a FL patients enrolled on the University of Iowa/Mayo Clinic Lymphoma SPORE Molecular Epidemiology Resource (MER) from 2002–2012 were initially evaluated. EFS was defined as time from diagnosis to progression, relapse, re-treatment, or death due to any cause. OS was compared to age-and-sex-matched survival in the general US population using standardized mortality ratios (SMR) and 95% confidence intervals (CI). We used a cohort of 412 FL patients from two Lyon, France hospital registries for independent replication. Patients who failed to achieve EFS12 had poor subsequent OS (MER SMR=3.72, 95%CI: 2.78–4.88; Lyon SMR=8.74, 95%CI: 5.41–13.36). Conversely, patients achieving EFS12 had no added mortality beyond the background population (MER SMR=0.73, 95%CI: 0.56–0.94, Lyon SMR=1.02, 95%CI: 0.58–1.65). Patients with early events after immunochemotherapy had especially poor outcomes (EFS12 failure: MER SMR=17.63, 95%CI:11.97–25.02, Lyon SMR=19.10, 95%CI:9.86–33.36; EFS24 failure: MER SMR=13.02, 95%CI:9.31–17.74, Lyon SMR=7.22, 95%CI:4.13–11.74). In a combined dataset of all patients from both cohorts, baseline FLIPI was no longer informative in EFS12 achievers. Reassessment of patient status at 12 months from diagnosis in follicular lymphoma patients, or at 24 months in patients treated with immunochemotherapy, is a strong predictor of subsequent overall survival in FL. Early event status provides a simple, clinically relevant endpoint for studies assessing outcome in FL.
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影响因子：
6.5
作者：
Ban-Hoefen, Makiko;Vanderplas, Ann;Friedberg, Jonathan W.
通讯作者：
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Unterhalt, M
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