伯基特淋巴瘤患者预后不良危险因素分析及预测模型  

Risk Factor Analysis and Prediction Model for Poor Prognosis in Patients with Burkitt Lymphoma

作　　者：王晓荣 白燕妮 WANG Xiaorong;BAI Yanni(The First Affiliated Hospital of PLA Air Force Medical University,Shaanxi Xi'an 710032,China)

机构地区：[1]中国人民解放军空军军医大学第一附属医院血液科,陕西西安710032

出　　处：《河北医学》2025年第3期490-495,共6页Hebei Medicine

基　　金：国家重点军事医学临床应用研究项目,(编号:JSYXM25)。

摘　　要：目的:分析伯基特淋巴瘤(BL)患者预后不良危险因素,建立预测模型。方法:选取空军军医大学第一附属医院血液科2018年2月至2024年1月收治的51例BL患者,治疗后进行定期随访,随访截止时间至2024年8月,分析其临床资料,检测其血清乳酸脱氢酶(LDH)水平,根据患着结局将其分为生存组(n=43)和死亡组(n=8),采用Cox回归分析影响BL患者预后不良的危险因素,采用Kaplan-Meier绘制生存曲线图,经Log-rank检验生存率。结果:本组51例患者化疗后CR 34例、PR 12例、SD 3例、PD 2例;ORR率为90.20%,DCR率为96.08%。随访至2024年8月,中位随访时间30个月,均未失访,复发6例,死亡8例,3年OS率、EFS率分别为84.31%、81.40%。Cox单因素回归分析显示:合并颌面部及中枢神经系统侵犯、LDH>1000U/L、单纯化疗、骨髓肿瘤细胞比例>25%、器官受累部位>4个、St.Jude分期Ⅲ+Ⅳ期、早期化疗不敏感、中期评估可见肿瘤病灶均与BL患者预后有关(P<0.05)。Cox多因素回归显示:合并颌面部及中枢神经系统侵犯、LDH>1000U/L、骨髓肿瘤细胞比例>25%是影响BL患者预后不良的独立危险因素(P<0.05)。结论:合并颌面部及中枢神经系统侵犯、LDH>1000U/L、骨髓肿瘤细胞比例>25%是影响BL患者预后不良的危险因素,针对上述因素需根据情况进行治疗,以改善患者预后。Objective:To analyze the risk factors for poor prognosis in patients with Burkitt lymphoma(BL)and establish a predictive model.Methods:A total of 51 BL patients admitted to our hospital from February 2018 to January 2024 were enrolled and followed up regularly until August 2024.Clinical data were collected,and serum lactate dehydrogenase(LDH)levels were measured.Patients were divided into a survival group(n=43)and a death group(n=8)based on outcomes.Cox regression analysis was used to identify risk factors for poor prognosis,and Kaplan-Meier survival curves were plotted,with survival rates compared using the Log-rank test.Results:Among the 51 patients,34 achieved complete remission(CR),12 had partial remission(PR),3 had stable disease(SD),and 2 had progressive disease(PD)after chemotherapy.The overall response rate(ORR)was 90.20%,and the disease control rate(DCR)was 96.08%.By August 2024,the median follow-up time was 30 months,with no loss to follow-up.Six patients experienced recurrence,and eight died.The 3-year overall survival(OS)rate and event-free survival(EFS)rate were 84.31%and 81.40%,respectively.Univariate Cox regression analysis showed that maxillofacial and central nervous system involvement,LDH>1000 U/L,chemotherapy alone,bone marrow tumor cell proportion>25%,involvement of>4 organ sites,St.Jude stage III+IV,early chemotherapy insensitivity,and visible tumor lesions at mid-term evaluation were associated with poor prognosis(P<0.05).Multivariate Cox regression identified maxillofacial and central nervous system involvement,LDH>1000 U/L,and bone marrow tumor cell proportion>25%as independent risk factors for poor prognosis(P<0.05).Conclusion:Maxillofacial and central nervous system involvement,LDH>1000 U/L,and bone marrow tumor cell proportion>25%are significant risk factors for poor prognosis in BL patients.Tailored treatment strategies targeting these factors may improve patient outcomes.

关 键 词：伯基特淋巴瘤 预后不良 危险因素 预测模型 

分 类 号：R73[医药卫生—肿瘤]