106例弥漫大B细胞淋巴瘤临床预后分析  

Clinical prognosis analysis of 106 patients with diffuse large B-cell lymphoma

作　　者：仵菲斐[1] 刘晓艳[1] 王亚楠[1] 甘思林[1] 王卫敏[1] 马杰[1] 孙慧[1] WU Feifei;LIU Xiaoyan;WANG Yanan;GAN Silin;WANG Weimin;MA Jie;SUN Hui(Department of Hemaetology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院血液内科,河南郑州450052

出　　处：《肿瘤基础与临床》2024年第1期33-37,共5页journal of basic and clinical oncology

摘　　要：目的探讨弥漫大B细胞淋巴瘤(DLBCL)的临床特征和生存预后因素。方法回顾性分析2017年4月至2022年5月郑州大学第一附属医院血液科收治的106例DLBCL患者的临床资料,分析其临床特征和预后相关因素。结果106例患者中,男64例,女42例,中位年龄62.5(19~87)岁,≥60岁者占52.8%(56/106),乳酸脱氢酶(LDH)升高者占66.0%(70/106),结外病变≥2处者占46.2%(49/106),骨髓受累者占20.8%(22/106),Ⅲ~Ⅳ期者占67.0%(71/106),国际预后指数(IPI)评分0、1分26.4%(28/106),2分22.6%(24/106),3分16.0%(17/106),4、5分34.9%(37/106)。接受化疗者102例,90例完成疗效评估,完全缓解率为52.2%(47/90),经分析LDH>240 u/L(χ^(2)=6.136,P=0.017)、IPI评分3~5分(χ^(2)=5.257,P=0.022)患者缓解率低。106例患者中位总生存期(OS)为533.5 d。单因素分析示年龄(χ^(2)=7.061,P=0.008)、B症状(χ^(2)=5.188,P=0.023)、骨髓受累(χ^(2)=14.074,P<0.001)、分期(χ^(2)=4.030,P=0.049)、LDH水平(χ^(2)=5.219,P=0.022)、β2-MG水平(χ^(2)=10.979,P=0.001)、IPI评分(χ^(2)=14.886,P=0.002)、化疗强度(χ^(2)=36.992,P=0.001)是DLBCL预后相关因素。多因素分析示LDH水平(HR=1.001,95%CI:1.000~1.001,P=0.004)、化疗强度(HR=0.403,95%CI:0.164~0.988,P=0.047)是影响DLBCL患者预后的独立因素。结论DLBCL预后是多因素影响的结果,LDH水平、化疗强度是影响预后的独立因素。Objective To investigate the clinical features and survival prognostic factors of diffuse large B-cell lymphoma(DLBCL).Methods The clinical data of 106 patients with DLBCL admitted to the Department of Hematology of the First Affiliated Hospital of Zhengzhou University from April 2017 to May 2022 were retrospectively analyzed.The clinical characteristics and prognostic factors were analyzed.Results Among the 106 patients,64 patients were males and 42 patients were females.The median age was 62.5(19-87)years old,52.8%(56/106)were≥60 years old,66.0%(70/106)had elevated lactate dehydrogenase(LDH),and 46.2%(49/106)had≥2 exodular lesions.Bone marrow involvement accounted for 20.8%(22/106),Ⅲ-Ⅳstage 67.0%(71/106),international prognostic index(IPI)score 0-1 point 26.4%(28/106),2 points 22.6%(24/106),3 points 16.0%(17/106),4-5 points 34.9%(37/106).Of 102 patients who received chemotherapy,90 patients completed the early efficacy evaluation,and the complete response rate was 52.2%(47/90).The analysis showed that patients with LDH>240 u/L(χ^(2)=6.136,P=0.017)and IPI points of 3-5(χ^(2)=5.257,P=0.022)had low response rate.The median overall survival(OS)of the 106 patients was 533.5 days.Univariate analysis showed age(χ^(2)=7.061,P=0.008),B symptoms(χ^(2)=5.188,P=0.023),bone marrow involvement(χ^(2)=14.074,P<0.001),stage(χ^(2)=4.03,P=0.049),LDH level(χ^(2)=5.219,P=0.022),β2-MG level(χ^(2)=10.979,P=0.001),IPI scores(χ^(2)=14.886,P=0.002),chemotherapy intensity(χ^(2)=36.992,P=0.001)were prognostic factors of DLBCL.Multivariate analysis showed that LDH level(HR=1.001,95%CI:1.0-1.001,P=0.004)and chemotherapy intensity(HR=0.403,95%CI:0.164-0.988,P=0.047)were independent factors affecting the prognosis of DLBCL patients.Conclusion The prognosis of DLBCL is the result of multiple factors,among which LDH level and chemotherapy intensity are independent factors affecting the prognosis.

关 键 词：弥漫大B细胞淋巴瘤 临床特征 预后 

分 类 号：R733.1[医药卫生—肿瘤]