文章：

多发性骨髓瘤中的疾病与结局差异：探讨合作组临床试验中种族/民族的作用

Disease and outcome disparities in multiple myeloma: exploring the role of race/ethnicity in the Cooperative Group clinical trials

原文发布日期：2018-07-06

DOI: 10.1038/s41408-018-0102-7

类型: Article

开放获取: 是

英文摘要：

Central nervous system (CNS) relapse of diffuse large B-cell lymphoma (DLBCL) is a devastating event occurring in ~ 5% of patients treated with R-CHOP. We hypothesized that adding lenalidomide to R-CHOP (R2CHOP) may decrease the risk of CNS relapse. We analyzed records for patients with DLBCL from two R2CHOP trials. We assessed variables pertinent to the CNS-International Prognostic Index (CNS-IPI) scoring system and classified patients into groups of low, intermediate, and high risk of CNS relapse. The 2-year CNS relapse rate for each risk group was estimated using the Kaplan–Meier method and compared with reported rates in cohorts treated with contemporary chemoimmunotherapy. A total of 136 patients were included. Mean age was 65 and median follow-up was 48.2 months. 10.3, 71.3, and 18.4% of patients were classified into low, intermediate, and high-risk CNS-IPI groups, respectively. Only one of 136 patients developed CNS relapse, corresponding to an incidence of 0.7% and an estimated 2-year CNS relapse rate of 0.9% for the entire R2CHOP cohort. The estimated 2-year CNS relapse rates for the low, intermediate, and high-risk groups were 0, 0, and 5.0%, respectively. Frontline therapy with R2CHOP in patients with DLBCL is associated with a lower-than-expected rate of CNS relapse.

摘要翻译： 

弥漫大B细胞淋巴瘤（DLBCL）的中枢神经系统（CNS）复发是一种毁灭性事件，发生在约5%接受R-CHOP治疗的患者中。我们假设在R-CHOP方案中加入来那度胺（R2CHOP）可能会降低CNS复发的风险。我们分析了来自两项R2CHOP试验的DLBCL患者记录。我们评估了与中枢神经系统国际预后指数（CNS-IPI）评分系统相关的变量，并将患者分为CNS复发的低风险、中风险和高风险组。使用卡普兰-迈耶方法估计了每个风险组的2年CNS复发率，并与接受当代化学免疫疗法治疗的队列中报告的比率进行了比较。总共纳入了136名患者。平均年龄为65岁，中位随访时间为48.2个月。分别有10.3%、71.3%和18.4%的患者被分类为低风险、中风险和高风险CNS-IPI组。136名患者中仅有一人发生CNS复发，相当于发生率为0.7%，整个R2CHOP队列的估计2年CNS复发率为0.9%。低风险、中风险和高风险组的估计2年CNS复发率分别为0%、0%和5.0%。在DLBCL患者中，使用R2CHOP作为一线治疗与低于预期的CNS复发率相关。

原文链接：

Disease and outcome disparities in multiple myeloma: exploring the role of race/ethnicity in the Cooperative Group clinical trials