Impact of comorbidity and relative dose intensity on outcomes in diffuse large B-cell lymphoma patients treated with R-CHOP
Impact of comorbidity and relative dose intensity on outcomes in diffuse large B-cell lymphoma patients treated with R-CHOP
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DOI：
10.1007/s00432-020-03279-7
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发表时间：
2020-06
影响因子：
3.6
通讯作者：
Masakazu Yamamoto;Ikuko Suzuki;K. Saitou;Riko Tsumanuma;Shuhei Okuyama;Hiroaki Kumagai;E. Omoto;S. Satoh;K. Tajima
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文献类型：
--
作者：
Masakazu Yamamoto;Ikuko Suzuki;K. Saitou;Riko Tsumanuma;Shuhei Okuyama;Hiroaki Kumagai;E. Omoto;S. Satoh;K. Tajima
背景弥漫性大b细胞淋巴瘤（DLBCL）患者的合并症和相对剂量强度（RDI）与生存相关，但这两种关系在同一患者中仍未得到解决。方法对2010年1月至2018年10月连续治疗的DLBCL患者进行回顾性分析。评估患者的临床特征数据，包括Charlson合并症指数（CCI）和RDI对其结果的影响。结果共分析211例患者，中位年龄72岁（范围19 ~ 90岁）。CCI≥2与较差的无事件生存期（EFS）和总生存期（OS）相关。RDI < 70%与较差的EFS和OS相关。一项多因素分析显示，RDI < 70%只是老年DLBCL患者（65岁<）OS降低的不良危险因素，与CCI的存在无关。以CCI≥2及以下、RDI≥70%为标准，分四组分析老年患者CCI与RDI的关系。CCI≥2、RDI < 70%组的OS和EFS较其他3组差。与CCI < 2、RDI < 70%和CCI≥2、RDI≥70%组相比，CCI < 2、RDI < 70%组有更好的OS，但EFS相同。结论scci≥2与预后较差相关，但维持RDI≥70%可能改善预后，尤其是老年DLBCL患者。
BackgroundComorbidity and relative dose intensity (RDI) have been associated with survival in diffuse large B-cell lymphoma (DLBCL) patients, but both relationships remain unaddressed in the same patients.MethodsA retrospective review of consecutive DLBCL patients treated from January 2010 to October 2018 was performed. Data for the clinical characteristics of the patients, including the Charlson Comorbidity Index (CCI) and RDI, on their outcomes were evaluated.ResultsA total of 211 patients with a median age of 72 years (range 19–90 years) were analyzed. CCI ≥ 2 was associated with poor event-free survival (EFS) and overall survival (OS). RDI < 70% was associated with worse EFS and OS. A multivariate analysis revealed that RDI < 70% was only a poor risk factor for the reduction of OS in elderly DLBCL patients (65 years <) and independent from the presence of CCI. The relationship between CCI and RDI in elderly patients was analyzed in four groups, based on CCI ≥ 2 or less and RDI ≥ 70% or less. The group with CCI ≥ 2 and RDI < 70% had a poorer OS and EFS, as compared to the other three groups. The group with CCI < 2 and RDI ≥ 70% had a superior OS but an identical EFS, as compared to the two groups with CCI < 2 and RDI < 70% and CCI ≥ 2 and RDI ≥ 70%.ConclusionsCCI ≥ 2 was associated with a poorer outcome, but maintaining RDI ≥ 70% may improve the outcome, especially in elderly DLBCL patients.