Follicular low‐grade non‐Hodgkin's lymphoma: Long‐term outcome with or without tumor progression
Follicular low‐grade non‐Hodgkin's lymphoma: Long‐term outcome with or without tumor progression
复制标题
滤泡性低度非霍奇金淋巴瘤：有或没有肿瘤进展的长期结果
DOI：
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发表时间：
1989
影响因子：
3.1
通讯作者：
N. Nissen
中科院分区：
文献类型：
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作者：
J. Ersbøll;H. Schultz;J. Pedersen‐Bjergaard;N. Nissen
研究了127例滤泡性低度恶性淋巴瘤患者的长期结局。治疗包括放疗（n = 23），低毒性化疗加或不加放疗（n = 76），或更强烈的化疗（n = 22）。6例患者未接受初始治疗。67%的患者获得完全缓解。60岁以下患者的中位生存期为8.7年，而老年患者为3.8年，但两个年龄组的淋巴瘤生存率相同：5年时为75%，10年时为58%。相对较低的肿瘤死亡率与10年时30%的无复发生存率以及首次缓解后8-9年的复发率形成对比。通过对78例复发性淋巴瘤患者的病灶分布和组织学亚型的稳定性进行分析，发现复发性淋巴瘤有两种不同的类型：1）肿瘤进展（淋巴瘤扩散至非典型淋巴结部位和/或组织学转化为中/高度淋巴瘤），见于56%的患者，10年时淋巴瘤生存率为13%; 2）44%的患者无肿瘤进展（淋巴结受累，组织学无改变），10年生存率为77%。5年时肿瘤进展的精算风险为44%，10年时为67%。除了大肿瘤负荷的负面影响外，不可能确定具有肿瘤进展高风险的患者。比所有治疗前因素更重要的是对初始治疗的反应差（p = 0.0001）。由于缺乏可靠的风险因素，建议所有年轻患者都以达到完全缓解为目的进行治疗;很大一部分可能是可治愈的。
Long‐term outcome for 127 patients with follicular low‐grade lymphoma was investigated. Therapy included radiotherapy (n = 23), low toxicity chemotherapy with or without radiotherapy (n = 76), or more intensive chemotherapy (n = 22). 6 patients had no initial therapy. Complete remission was obtained in 67% of patients. For patients under 60 years of age median survival was 8.7 yr compared with 3.8 yr for older patients, but survival from lymphoma was identical for the two age‐groups: 75% at 5 yr, and 58% at 10 yr. The relatively low tumor mortality contrasted with a relapse‐free survival of 30% at 10 yr, and relapse 8–9 yr after first remission. Examining the disease topography and the stability of histologic subtype in 78 patients with recurrent lymphoma, two types of relapse with different prognoses were identified: 1) with tumor progression (lymphoma dissemination to atypical extranodal sites and/or histologic conversion to an intermediate/high‐grade lymphoma) seen in 56% of patients with a survival from lymphoma of 13% at 10 yr; and 2) without tumor progression (involvement of nodal sites, and unchanged histology) seen in 44% with a survival from lymphoma of 77% at 10 yr. Actuarial risk of tumor progression was 44% at 5 yr, and 67% at 10 yr. Except from the negative impact of a large tumor burden, it was not possible to identify patients with high risk for tumor progression. More important than all pretreatment factors was poor response to initial therapy (p = 0.0001). Due to lack of reliable risk factors, it is recommended that all younger patients be treated with the intention of achieving complete remission; a significant fraction might be curable.
结节性淋巴细胞低分化淋巴瘤的中度化疗与侵袭性化疗。
DOI：
10.1200/jco.1985.3.6.769
发表时间：
1985
期刊：
Journal of clinical oncology : official journal of the American Society of Clinical Oncology
影响因子：
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作者：
Ezdinli,EZ;Anderson,JR;Melvin,F;Glick,JH;Davis,TE;O'Connell,MJ
通讯作者：
O'Connell,MJ
DOI：
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发表时间：
1972
期刊：
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影响因子：
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作者：
D. Cox
通讯作者：
D. Cox