文章：

低绝对外周血CD4+T细胞计数可预测接受R-CHOP治疗的弥漫大B细胞淋巴瘤患者的不良预后

Low absolute peripheral blood CD4+ T-cell count predicts poor prognosis in R-CHOP-treated patients with diffuse large B-cell lymphoma

原文发布日期：2017-04-21

DOI: 10.1038/bcj.2017.37

类型: Original Article

开放获取: 是

英文摘要：

The absolute peripheral blood lymphocyte count at diagnosis is known to be a strong prognostic factor in patients with diffuse large B-cell lymphoma (DLBCL) treated with rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP), but it remains unclear as to which peripheral blood lymphocyte population is reflective of DLBCL prognosis. In this cohort, 355 patients with DLBCL treated with R-CHOP from 2006 to 2013 were analyzed. The low absolute CD4+ T-cell count (ACD4C) at diagnosis negatively correlated with the overall response rate and the complete response rate significantly (P<0.00001). An ACD4C<343 × 106/l had a significant negative impact on the 5-year progression-free survival and the overall survival as compared with an ACD4C⩾343 × 106/l (73.7% (95% confidence interval (CI)=66.7–79.5) versus 50.3% (95% CI=39.0–60.6), P<0.00001 and 83.3% (95% CI=77.1–88.0) versus 59.0% (95% CI=47.9–68.5), P<0.00000001, respectively). Multivariate analysis revealed that the ACD4C was an independent prognostic marker (hazard ratio=2.2 (95% CI=1.3–3.7), P<0.01). In conclusion, a low ACD4C at diagnosis served as an independent poor prognostic marker in patients with DLBCL.

摘要翻译： 

确诊时的绝对外周血淋巴细胞计数已知是使用利妥昔单抗、环磷酰胺、多柔比星、长春新碱和泼尼松（R-CHOP）治疗的弥漫大B细胞淋巴瘤（DLBCL）患者的一个重要预后因素，但尚不清楚哪种外周血淋巴细胞群能够反映DLBCL的预后。本队列分析了2006年至2013年间接受R-CHOP治疗的355例DLBCL患者。确诊时低绝对CD4+ T细胞计数（ACD4C）与总缓解率和完全缓解率显著负相关（P<0.00001）。与ACD4C≥343×10^6/L相比，ACD4C<343×10^6/L对5年无进展生存率和总生存率有显著的负面影响（分别为73.7%（95%置信区间[CI]=66.7–79.5）对比50.3%（95% CI=39.0–60.6），P<0.00001；以及83.3%（95% CI=77.1–88.0）对比59.0%（95% CI=47.9–68.5），P<0.00000001）。多变量分析显示，ACD4C是一个独立的预后标志物（危险比=2.2（95% CI=1.3–3.7），P<0.01）。总之，确诊时低ACD4C可作为DLBCL患者一个独立的不良预后标志物。

原文链接：

Low absolute peripheral blood CD4+ T-cell count predicts poor prognosis in R-CHOP-treated patients with diffuse large B-cell lymphoma