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Prognostic study of 229 follicular lymphoma patients treated with rituximab combined with chemotherapy



Prognostic study of 229 follicular lymphoma patients treated with rituximab combined with chemotherapy



Zhonghua Xue Ye Xue Za Zhi 40(1): 46-51



目的: 探究滤泡性淋巴瘤(FL)的临床特征,以及FL国际预后指数(FLIPI)、FLIPI2、IPI、修正IPI(R-IPI)、NCCN-IPI在中国FL患者的预后意义。 方法: 对2008年11月至2018年4月期间以利妥昔单抗联合CHOP(环磷酰胺、多柔比星、长春新碱及泼尼松)方案治疗的229例初治FL患者资料进行回顾性分析,并对所有患者进行各项预后指数评分。对201例完成化疗且有完整随访记录的患者进行单因素及多因素生存分析。 结果: 229例患者中男126例,女103例,中位年龄53(21~82)岁。①对上述预后评分系统中所含的危险因素在患者总生存(OS)和无进展生存(PFS)中的影响进行分析,单因素分析结果显示:年龄>60岁、HGB<120 g/L、血β(2)微球蛋白升高、骨髓浸润及C反应蛋白(CRP)升高是影响患者OS和PFS的不良因素(P值均<0.05),利妥昔单抗维持组(RM)与非维持组(non-RM)患者的5年OS率分别为93.33%、87.10%(P=0.020),5年PFS率分别为90.81%、63.47%(P=0.003),前者均优于后者;多因素分析结果显示:HGB<120 g/L(P=0.001)、骨髓浸润(P=0.050)、CRP升高(P=0.010)和non-RM(P=0.010)是影响OS的不良预后因素,HGB<120 g/L(P=0.003)、CRP升高(P=0.009)和non-RM(P=0.003)是影响PFS的不良预后因素。②对FLIPI和FLIP2评分预后模型进行比较分析,结果显示:FLIPI预后模型中,低危、中危和高危组患者的5年OS率(P=0.230)和5年PFS率(P=0.160)差异均无统计学意义。FLIP2预后模型中,5年OS率和5年PFS率差异均有统计学意义(P值均<0.001),在利妥昔单抗治疗组中进行分析,低危、中危和高危组患者的5年OS率分别为96.77%、88.89%、80.00%,差异有统计学意义(P=0.042)。 结论: 利妥昔单抗时代FLIPI2可以更好地用于FL危险分层。.

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Accession: 066446346

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PMID: 30704228


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