Incidence, predictive factors, and outcome of lymphoma transformation in follicular lymphoma patients
Incidence, predictive factors, and outcome of lymphoma transformation in follicular lymphoma patients
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DOI：
10.1200/jco.1997.15.4.1587
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发表时间：
1997-04-01
影响因子：
45.3
通讯作者：
Coiffier, B
中科院分区：
文献类型：
--
作者：
Bastion, Y;Sebban, C;Coiffier, B
目的：为了评估滤泡性淋巴瘤（FL）患者自然史中淋巴瘤转化的发生率以及预测该事件的因素，患者和方法：1975年至1990年期间在我们机构治疗的220例FL患者，α中位数随访时间为9年，包括在本回顾性分析中。34例患者的组织学或13例患者的细胞学证实了转化，5例患者的临床参数被认为是高度可能的，总发生率为24%。5年时转化概率为22%，10年时为31%，6年后趋于平稳。转化的预测因素为初始治疗后未达到完全缓解（CR）（P < 10 - 4）、诊断时低血清白蛋白水平（< 35 g/L）（P = 0.001）和β 2-微球蛋白水平大于3 mg/L（P = 0.02）。在多参数分析中，只有β 2-微球蛋白水平对免于转化（FFT）生存率具有预后意义（P = 0.04）。转化占44%的死亡，并与一个不良的结果，与α中位生存时间为7 months.Conclusion：转化是在疾病的过程中的早期事件，主要是在已知的不良预后因素的患者或那些谁没有达到CR后，初步治疗。这些发现可能是有用的选择滤泡性淋巴瘤患者的强化治疗方法。(C)1997年，美国临床肿瘤学会。
Purpose: To assess the incidence of lymphoma transformation in the natural history of follicular lymphoma (FL) patients and the factors that are predictive of this event.Patients and Methods: Two hundred twenty patients with FL treated in our institution between 1975 and 1990, with alpha median follow-up duration of 9 years, were included in this retrospective analysis.Results: Transformation was proven by histology in 34 patients or by cytology in 13 patients and was considered as highly probable on clinical arguments in five patients for an overall incidence of 24%. The probability of transformation was 22% at 5 years and 31% at 10 years and tended to plateau after 6 years. Predictive factors for transformation were nonachievement of complete remission (CR) after initial therapy (P < 10(-4)), low serum albumin level (< 35 g/L) (P = .001), and beta(2)-microglobulin level greater than 3 mg/L (P = .02) at diagnosis. In a multiparametric analysis, only beta(2)-microglobulin level retained prognostic significance for freedom-from-transformation (FFT) survival (P = .04). Transformation accounted for 44% of deaths and was associated with a poor outcome, with alpha median survival time of 7 months.Conclusion: Transformation is on early event in the course of the disease and is mainly observed in patients with known adverse prognostic factors or those who do not achieve CR after initial treatment. These findings may be useful to select follicular lymphoma patients for intensive therapeutic approaches. (C) 1997 by American Society of Clinical Oncology.