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一线RCHOP方案治疗不同组织学亚型滤泡性淋巴瘤3级患者的临床疗效

Clinical efficiency of frontline RCHOP regimen in treatment of follicular lymphoma grade 3 patients with different histological subtypes

    摘要
  • 摘要:
    目的 探讨一线RCHOP方案治疗不同组织学亚型滤泡性淋巴瘤（follicular lymphoma，FL）3级患者患者的临床疗效。
    方法 回顾性分析2009年1月至2019年12月复旦大学附属中山医院收治的初诊并予一线RCHOP方案治疗的61例FL 3级患者的临床资料。患者分为FL 3A级组（n=42）和侵袭性FL组（n=19），侵袭性FL组包括3A级合并3B级2例、3B级8例和FL 3级伴弥漫大B细胞淋巴瘤成分9例。
    结果 两组患者性别、年龄、β2微球蛋白水平、乳酸脱氢酶水平、AnnArbor分期、B组症状、骨髓受累等差异均无统计学意义。中位随访时间为40.2个月。2组患者的3年总生存（OS）率分别为97.1%、81.9%，差异有统计学意义（P=0.041）；3年无进展生存（PFS）率分别为69.1%、71.1%（P=0.546）。侵袭性FL组患者2年后出现PFS平台期。
    结论 一线RCHOP方案治疗FL 3A级患者3年总生存率优于侵袭性FL，但两者的PFS差异无统计学意义，侵袭性FL患者治疗2年后出现PFS平台期。

     

    Abstract:
    Objective To explore the clinical features and outcomes of follicular lymphoma (FL) grade 3 treated with frontline RCHOP regimen.
    Methods 61 FL grade 3 patients treated with frontline RCHOP regimen between January 2009 and December 2019 were retrospectively analyzed. We divided them into FL grade 3A (n=42) and aggressive FL (n=19). Aggressive FL included grade 3A with an additional 3B component (n=2), grade 3B (n=8), and grade 3 with areas of diffuse large B cell lymphoma (n=9).
    Results The baseline characteristics, including gender, age, serum β2 microglobulin and lactate dehydrogenase levels, Ann Arbor stage, B symptom and bone marrow involvement were similar between FL grade 3A and aggressive FL. After a median follow-up period of 40.2 months, the 3-year overall survival (OS) rate was 97.1% in FL grade 3A and 81.9% in aggressive FL, (P=0.041). The 3-year progression free survival (PFS) rate was 69.1% and 71.1%, respectively, (P=0.546). Patients of aggressive FL reached a plateau in the PFS curve after 2 years.
    Conclusions The 3-year OS survival rate of the frontline RCHOP regimen in the treatment of FL3A patients was better than that of aggressive FL, but the PFS difference between the two was not statistically significant. PFS plateau appears after 2 years of treatment in aggressive FL patients.

     

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