摘要
目的:观察含BTK抑制剂的化疗方案治疗复发难治套细胞淋巴瘤(MCL)的疗效及预后。方法:回顾性分析134例复发难治MCL患者的临床资料,观察患者临床特征,以及化疗方案对疗效、总生存(OS)率及无进展生存(PFS)率的影响。结果:患者中位年龄58(56-61)岁,男女比例约为2.9∶1,Ann Arbor分期Ⅲ-Ⅳ期患者占77.6%,结外受累部位>2占43.3%,骨髓受累占60.4%,胃肠道受累占24.6%,肝脾肿大占38.1%。中位随访时间30(2-103)个月,总有效率41.8%,3年PFS未达到,3、5年OS率分别为62.7%、53.8%。含BTK抑制剂方案治疗组总有效率56.9%,优于不含BTK抑制剂方案治疗组的32.5%,比较差异有统计学意义(P=0.006),两组PFS率差异亦有统计学意义(P=0.002),而OS率差异无统计学意义(P>0.05)。经典型与特殊型之间PFS率差异无统计学意义(P>0.05),而OS率差异有统计学意义(P<0.001)。Ki-67是复发难治MCL患者OS和PFS的影响因素。Ki-67、B症状、套细胞淋巴瘤国际预后指数评分、Ann Arbor分期是影响患者OS的独立预后因素。二线治疗方案是影响患者PFS的独立预后因素。结论:含BTK抑制剂方案治疗复发难治MCL有效率高,且可明显延长PFS,Ki-67、B症状、套细胞淋巴瘤国际预后指数评分、Ann Arbor分期为复发难治MCL的独立预后因素。
Objective:To investigate the efficacy and prognosis of chemotherapy regimen containing Bruton′s tyrosine kinase(BTK)inhibitor in the treatment of relapsed/refractory mantle cell lymphoma(R/R MCL).Methods:The clinical data of 134 patients with R/R MCL were collected and analyzed retrospectively.The clinical characteristics of patients and effect of chemotherapy regimen on efficacy,overall survival(OS)and progression-free survival(PFS)were observed.Results:The median age of the patients was 58(56-61)years old,and male to female ratio was about 2.9∶1.Patients with Ann Arbor stage III-IV accounted for 77.6%,extranodal involvement>2 for 43.3%,bone marrow involvement for 60.4%,gastrointestinal involvement for 24.6%,and hepatosplenomegaly for 38.1%.The median follow-up time was 30(2-103)months,overall response rate(ORR)was 41.8%,3-year PFS was not reached,and 3-year and 5-year OS rate was 62.7%and 53.8%,respectively.The ORR of BTK inhibitor group was 56.9%,which was higher than 32.5%of non-BTK inhibitor group(P=0.006).The difference was statistically significant in PFS between the two groups(P=0.002),but was not in OS(P>0.05).The difference was statistically significant in OS between classical and special morphology(P<0.001),but was not in PFS(P>0.05).Ki-67 was an influencing factor for OS and PFS.Multivariate analysis showed that Ki-67,B symptoms,MIPI score,and Ann Arbor stage were independent prognostic factors affecting patients′OS.The secondline treatment regimen was an independent prognostic factor affecting patients′PFS.Conclusions:The chemotherapy regimen containing BTK inhibitors can effectively improve the efficacy and prolong the PFS of R/R MCL patients.Ki-67,B symptoms,MIPI score,and Ann Arbor stage are independent prognostic factors for R/R MCL patients.
作者
陈欢
柳喜洋
常宇
陈子琪
李文琪
张蕾
CHEN Huan;LIU Xi-Yang;CHANG Yu;CHEN Zi-Qi;LI Wen-Qi;ZHANG Lei(Departmert of Oncology,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,Henan Province,China)
出处
《中国实验血液学杂志》
CSCD
北大核心
2024年第1期125-131,共7页
Journal of Experimental Hematology
基金
国家自然科学基金青年会基金(82000204)。
关键词
BTK抑制剂
复发难治套细胞淋巴瘤
生存
预后
BTK inhibitor
relapsed/refractory mantle cell lymphoma
survival
prognosis
