52例初治高级别及转化滤泡淋巴瘤患者临床特征及预后分析  

Clinical characteristics and survival analysis of de novo grade 3 or transformed follicular lymphoma patients

作　　者：应志涛[1] 冯海英[2] 米岚[1] 宋玉琴[1] 王小沛[1] 郑文[1] 林宁晶[1] 涂梅峰[1] 谢彦[1] 平凌燕 张晨[1] 刘卫平[1] 邓丽娟[1] 朱军[1] Ying Zhitao;Feng Haiying;Mi Lan;Song Yuqin;Wang Xiaopei;Zheng Wen;Lin Ningjing;Tu Meifeng;Xie Yan;Ping Lingyan;Zhang Chen;Liu Weiping;Deng Lijuan;Zhu Jun(Department of Lymphoma,Key laboratory of Carcinogenesis and Translational Research（Ministry of Education）,Peking University Cancer Hospital ＆ Institute,Beijing 100142,China)

机构地区：[1]北京大学肿瘤医院暨北京市肿瘤防治研究所恶性肿瘤发病机制及转化研究教育部重点实验室,100142 [2]河北省黄骅市人民医院

出　　处：《中华血液学杂志》2018年第9期745-750,共6页Chinese Journal of Hematology

基　　金：人社部出国留学人员科技活动项目[人社厅函（2016）176号];北京市医院管理局临床医学发展专项（XMLX201502）

摘　　要：目的探讨初治3级或伴有大B细胞转化滤泡淋巴瘤（FL）患者的临床特征及预后。方法收集2009年1月至2017年9月在北京大学肿瘤医院诊断治疗的52例FL患者资料，对患者的基本临床特征、生存及预后因素进行统计学分析。结果①52例患者中，男女各26例，其中3A级28例，3B级13例，伴大B细胞转化11例。②整组患者的3年无进展生存（PFS）率为56．0％，3年总生存（OS）率为80．6％。IPI评分0～1分者较2—3分者的3年PFS率（80．3％对20．1％，t=18．902，P〈0．001）和OS率（95．7％对57．0％，t=10．406，P〈0．001）高；FLIPI1评分低、中、高危组患者的3年PFS率分别为94．1％、37．2％、25．2％（P=0．002），3年OS率分别为100％、76．0％、59．8％（P=0．020），FLIPI2评分低、中、高危组患者的3年PFS率分别为68．4％、0、0（P=0．001），3年OS率分别为87．5％、76．2％、0（P=0．003），差异均有统计学意义。③多因素分析显示，IPI评分≥2分是影响患者PFS（HR=3．536，P=0．015）和OS（HR=15．713，P=0．015）的不良预后因素；FLIPI2评分与患者OS（以≥3分为参照，0～1分：HR=0．078，P=0．007；2分：HR=0．080，P=0．022）显著相关。结论以现有治疗手段，初治高级别FL和伴大B细胞转化FL有可能治愈，IPI评分仍可以预测该组患者预后。Objective To evaluate the clinical characteristics and survival outcomes of patients with de novo grade 3 or transformed follicular lymphoma （FL）. Methods Fifty-two patients treated at Peking University Cancer Hospital between January 2009 and September 2017 were assessed, including 28 patients with FL 3A grade, 13 patients with FL 3B grade, 11 patients with transformed FL. Baseline characteristics, survival and prognostic factors were analyzed. Results （1） Twenty-six male and 26 female patients were enrolled, including 28 patients with FL 3A grade, 13 patients with FL 3B grade, 11 patients with transformed FL. （2）The 3-year progression-free survival （PFS） and overall survival （OS） for the entire cohort were 56.0% and 80.6%, respectively. Patients with international prognostic index （IPI） score 0-1 demonstrated significantly better 3-year PFS （80.3% vs 20.1%; t = 18.902, P 〈 0.001） and OS （95.7% vs 57.0%; t= 10.406, P〈 0.001） than patients with IPI score 2-3. Three-year PFS （94.1% vs 37.2% vs 25.2%; P = 0.002） and OS （100.0% vs 76.0% vs 59.8%; P = 0.020） were also significantly different among patients with FLIPI 1 score 0-1, 2, ≥3. FLIPI 2 score was also identified as a prognostic factor for 3-year PFS （68.4%, 0, 0; P=0.001） and OS（87.5%, 76.2%, 0; P= 0.003）. （3）Multivariate analysis indicated a significant association of PFS （HR = 3.536, P = 0.015） and OS （HR = 15.713, P= 0.015） with IPI. FLIPI 2 was associated with OS （score 0-1, HR = 0.078, P = 0.007; score 2, HR = 0.080, P = 0.022）. Conclusion De novo grade 3 or transformed FL might be a group of curable disease with current treatment strategies. IPI is still a prognostic tool in this scenario.

关 键 词：淋巴瘤 滤泡性 高级别 细胞转化 肿瘤 预后 

分 类 号：R733.1[医药卫生—肿瘤]