滤泡性淋巴瘤国际预后指数2在利妥昔单克隆抗体维持治疗滤泡性淋巴瘤患者中的预后意义

发布时间：2018-05-18 13:51

本文选题：滤泡性淋巴瘤 + 滤泡性淋巴瘤国际预后指数　；参考：《中国实验血液学杂志》2017年02期

【摘要】：目的:探讨滤泡性淋巴瘤国际预后指数2(FLIPI2)在滤泡性淋巴瘤(FL)中的预后意义,以期寻找更适合维持治疗的人群,为个体化治疗进行更深入的探索。方法:对2002年12月至2014年12月以利妥昔单克隆抗体联合环磷酰胺、多柔比星、长春新碱及泼尼松(R-CHOP)化疗方案治疗的140例初治FL患者进行回顾性分析。140例中122例经过治疗后获得缓解,其中56例接受2个月1次利妥昔单克隆抗体维持(RM),中位维持8次(RM组);66例不接受任何抗淋巴瘤药物治疗(non-RM组)。结果:RM组及non-RM组在年龄、性别、病理分级、Ann Arbor分期、FLIPI及FLIPI2评分等临床及病理特征方面均无显著性差异。RM组和non-RM组的2年无进展生存(PFS)分别为89.7%和77.6%(P=0.043),其2年总生存(OS)分别为100%和98.6%(P=0.131)。无论在整体队列、RM组或non-RM组中,FLIPI2均可将患者分为预后显著差异的3个危险组别(P0.001)。亚组分析显示,FLIPI2低危及中危患者RM组较non-RM组的PFS显著提升;但在FLIPI2高危组中,RM与non-RM组的2年PFS率分别为55.6%和46.9%(P=0.920)。结论:经一线R-CHOP方案治疗缓解的FL患者,无论是否行RM,FLIPI2均对其预后判别具有重要意义。FLIPI2低危及中危患者均可以从RM治疗中获益,但是高危患者中RM治疗的意义仍值得进一步明确。
[Abstract]:Objective: to explore the prognostic significance of international prognostic index (IFPI _ 2) of follicular lymphoma in follicular lymphoma. Methods: from December 2002 to December 2014, the monoclonal antibodies against rituxime combined with cyclophosphamide, doxorubicin, A retrospective analysis of 140 newly diagnosed FL patients treated with vincristine and prednisone R-CHOP-based chemotherapy was performed. 122 of the 140 patients received remission after treatment. Among them, 56 patients were treated with RMV once in 2 months, 66 patients in the RM group were not treated with any anti-lymphoma drugs, and 66 patients in the RM group were not treated with any anti-lymphoma drugs. Results there was no significant difference in age, sex, clinicopathologic features of Ann Arbor staging, FLIPI and FLIPI2 score between the two groups. The 2-year progression free survival (PFSs) of the RM group and the non-RM group were 89.7% and 77.6%, respectively. The total survival rates of the two years were 100% and 98.6m respectively. In either the whole cohort RM group or non-RM group, the patients could be divided into 3 risk groups with significant difference in prognosis (P 0.001). The subgroup analysis showed that the PFS of RM group was significantly higher than that of non-RM group, but the 2-year PFS rate of RM group and non-RM group were 55.6% and 46.9% respectively. Conclusion: it is important for the prognosis of FL patients treated with first-line R-CHOP regimen to treat remission with or without RMM-FLIPI2.The patients with moderate risk of low risk of FLIPI2 can benefit from RM therapy. However, the significance of RM treatment in high-risk patients is still worthy of further clarification.
【作者单位】：上海交通大学医学院附属瑞金医院血液科;上海市静安区北站医院血液科;
【基金】：上海市科学技术委员会科研计划(08411953900) 瑞金医院优秀青年教师(800000000003) 上海交通大学晨星青年学者奖励计划上海市青年医师培养资助计划
【分类号】：R733.1

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