Splenic marginal zone lymphoma: a prognostic model for clinical use
Splenic marginal zone lymphoma: a prognostic model for clinical use
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DOI：
10.1182/blood-2005-11-4659
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发表时间：
2006-06-15
期刊：
影响因子：
20.3
通讯作者：
Iannitto, Emilio
中科院分区：
文献类型：
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作者：
Arcaini, Luca;Lazzarino, Mario;Iannitto, Emilio
Integruppo Itallano Linfomi (IIL) 开展了一项研究，以评估 309 名患者的脾边缘区淋巴瘤的结果并确定预后因素。 5 年病因特异性生存率 (CSS) 为 76%。在单变量分析中，预测较短 CSS 的参数为血红蛋白水平低于 12 g/dL (P < .001)、白蛋白水平低于 3.5 g/dL (P = .001)、国际预后指数 (IPI) 评分为 2 至 3 (P < .001)、乳酸脱氢酶 (LDH) 水平高于正常值 (P < .001)、年龄超过 60 岁 (P = .01)、血小板计数低于 100 000/μL (P = .04)、HbsAg 阳性 (P = .01)、诊断时未进行脾切除 (P = .006)。在多变量分析中，对 CSS 保持负面影响的值为血红蛋白水平低于 12 g/dL、LDH 水平高于正常值以及白蛋白水平低于 3.5 g/dL。利用这 3 个变量，我们将患者分为 3 个预后类别：没有不良因素的低风险组 (41%)、有 1 个不良因素的中风险组 (34%)、有 2 或 3 个不良因素的高风险组 (25%)。低风险组的5年CSS率为88%，中风险组为73%，高风险组为50%。低风险组的具体原因死亡率（x 1000人年）为20，中风险组为47，高风险组为174。后者占所有淋巴瘤相关死亡的 54%。总之，通过使用现成的因素，该预后指数可能是评估个体患者治疗需求和治疗强度的有效工具。
The Integruppo Itallano Linfomi (IIL) carried out a study to assess the outcomes of splenic marginal zone lymphoma and to identify prognostic factors in 309 patients. The 5-year cause-specific survival (CSS) rate was 76%. In univariate analysis, the parameters predictive of shorter CSS were hemoglobin levels below 12 g/dL (P < .001), albumin levels below 3.5 g/dL (P = .001), International Prognostic Index (IPI) scores of 2 to 3 (P < .001), lactate dehydrogenase (LDH) levels above normal (P < .001), age older than 60 years (P = .01), platelet counts below 100 000/ mu L (P = .04), HbsAg-positivity (P = .01), and no splenectomy at diagnosis (P = .006). Values that maintained a negative influence on CSS in multivariate analysis were hemoglobin level less than 12 g/dL, LDH level greater than normal, and albumin level less than 3.5 g/dL. Using these 3 variables, we grouped patients into 3 prognostic categories: low-risk group (41%) with no adverse factors, Intermediate-risk group (34%) with one adverse factor, and high-risk group (25%) with 2 or 3 adverse factors. The 5-year CSS rate was 88% for the low-risk group, 73% for the intermediate-risk group, and 50% for the high-risk group. The cause-specific mortality rate (x 1000 person-years) was 20 for the low-risk group, 47 for the intermediate-risk group, and 174 for the high-risk group. This latter group accounted for 54% of all lymphoma-related deaths. In conclusion, with the use of readily available factors, this prognostic index may be an effective tool for evaluating the need for treatment and the intensity of therapy in an individual patient.