文章：

现代时期复发套细胞淋巴瘤患者的生存模式：每次复发后缓解持续时间和生存期逐渐缩短

Patterns of survival in patients with recurrent mantle cell lymphoma in the modern era: progressive shortening in response duration and survival after each relapse

原文发布日期：2019-05-20

DOI: 10.1038/s41408-019-0209-5

类型: Article

开放获取: 是

英文摘要：

As the survival of patients with mantle cell lymphoma (MCL) continues to improve, patients are increasingly being treated with multiple regimens. However, outcome after each line remains poorly characterized in the modern era. To address this knowledge gap, we retrospectively studied 404 consecutive MCL patients who were managed between 2000 and 2014 at Memorial Sloan Kettering Cancer Center. Histologic diagnosis was centrally confirmed, and patients were followed longitudinally from diagnosis throughout their disease course. Progression-free survival (PFS) and overall survival (OS) were determined by Kaplan–Meier method. The median OS and PFS after first-line treatment were 9.7 and 4.0 years, respectively. After second-line therapy, the median OS and PFS were 41.1 and 14.0 months, third line were 25.2 and 6.5 months, and fourth line were 14.4 and 5.0 months. In patients less than 65 years, stem cell transplant (SCT)-based frontline regimens were associated with improved PFS compared with non-SCT regimens (median PFS: 86.2 versus 40.0 months; P < 0.01), with a trend toward longer OS (median OS: 165.0 versus 120.0 months; P = 0.06). Early treatment failure after first-line regimens was associated with worse OS (5.9 versus 2.5 years; P < 0.01). Our study should facilitate establishing proper endpoints for future clinical trials using novel treatment approaches.
 

摘要翻译： 

随着套细胞淋巴瘤（MCL）患者生存期的持续改善，患者接受多线治疗方案的情况日益普遍。然而在现代治疗背景下，各线治疗后的转归仍缺乏明确特征。为填补这一认知空白，我们回顾性研究了2000年至2014年间在纪念斯隆-凯特琳癌症中心连续收治的404例MCL患者。所有病例均经中心病理确诊，并对患者从诊断至病程全程进行纵向随访。采用Kaplan-Meier法计算无进展生存期（PFS）和总生存期（OS）。一线治疗后中位OS和中位PFS分别为9.7年与4.0年；二线治疗后中位OS和PFS分别为41.1个月与14.0个月；三线治疗后分别为25.2个月与6.5个月；四线治疗后分别为14.4个月与5.0个月。在65岁以下患者中，基于干细胞移植（SCT）的一线方案较非SCT方案显著改善PFS（中位PFS：86.2个月 vs 40.0个月；P<0.01），并呈现延长OS趋势（中位OS：165.0个月 vs 120.0个月；P=0.06）。一线方案后早期治疗失败与较差的OS显著相关（5.9年 vs 2.5年；P<0.01）。本研究将为建立新型治疗方案临床试验的合理终点提供参考依据。

原文链接：

Patterns of survival in patients with recurrent mantle cell lymphoma in the modern era: progressive shortening in response duration and survival after each relapse