文章：

现代滤泡性淋巴瘤：生存、治疗结局及高危亚组的识别

Follicular lymphoma in the modern era: survival, treatment outcomes, and identification of high-risk subgroups

原文发布日期：2020-07-17

DOI: 10.1038/s41408-020-00340-z

类型: Article

开放获取: 是

英文摘要：

Patients with follicular lymphoma (FL) frequently require multiple treatments during their disease course; however, survival based on lines of treatment remains poorly described in the post-rituximab era. Also, the Follicular Lymphoma International Prognostic Index (FLIPI) score was developed to predict survival at diagnosis, yet it remains unknown whether increase in FLIPI score following an initial observation period is associated with less-favorable outcomes. To address these knowledge gaps, we retrospectively studied 1088 patients with FL grade 1–3A managed between 1998 and 2009 at our institution. Median overall survival (OS) and progression-free survival (PFS) after first-line treatment were not reached and 4.73 years, respectively. Following successive lines of treatment, years of median OS and PFS were, respectively: after second-line, 11.7 and 1.5; third-line, 8.8 and 1.1; fourth-line, 5.3 and 0.9; fifth-line, 3.1 and 0.6; sixth-line, 1.9 and 0.5. In initially observed, subsequently treated patients, FLIPI score increase after observation was associated with inferior survival following first-line treatment. The reduced survival we observed after second-line and later therapy supports the development of new treatments for relapsed patients and benchmarks historical targets for clinical endpoints. This study also highlights the utility of changes in FLIPI score at diagnosis and after observation in identifying patients likely to have worse outcomes.
 

摘要翻译： 

滤泡性淋巴瘤（FL）患者在病程中常需多次治疗；然而，在利妥昔单抗时代，基于治疗线数的生存状况仍鲜有描述。此外，滤泡性淋巴瘤国际预后指数（FLIPI）虽被开发用于诊断时预测生存，但目前尚不明确初始观察期后FLIPI评分的升高是否与不良预后相关。为填补这些认知空白，我们回顾性研究了1998年至2009年间在本机构收治的1088例1-3A级FL患者。一线治疗后中位总生存期（OS）未达到，中位无进展生存期（PFS）为4.73年。后续治疗线数的中位OS与PFS分别为：二线治疗后11.7年与1.5年；三线后8.8年与1.1年；四线后5.3年与0.9年；五线后3.1年与0.6年；六线后1.9年与0.5年。在初始观察后接受治疗的患者中，观察期后FLIPI评分升高与一线治疗后较差生存率相关。我们观察到的二线及后续治疗后生存期缩短，支持为复发患者研发新疗法，并为临床终点设定了历史参照基准。本研究还揭示了诊断时及观察后FLIPI评分变化在识别潜在不良预后患者中的实用价值。

原文链接：

Follicular lymphoma in the modern era: survival, treatment outcomes, and identification of high-risk subgroups