文章：

瑞典一项基于人群的4243例患者队列中复发/难治性弥漫大B细胞淋巴瘤（DLBCL）的发病率，包括中枢神经系统复发

Incidence of relapsed/refractory diffuse large B-cell lymphoma (DLBCL) including CNS relapse in a population-based cohort of 4243 patients in Sweden

原文发布日期：2021-01-07

DOI: 10.1038/s41408-020-00403-1

类型: Article

开放获取: 是

英文摘要：

We performed a national population-based study of all patients diagnosed with diffuse large B-cell lymphoma (DLBCL) in Sweden in 2007–2014 to assess treatment intent and risk of relapsed/refractory disease, including central nervous system (CNS) relapse, in the presence of competing risks. Overall, 84% of patients started treatment with curative intent (anthracycline-based) (n = 3550, median age 69 years), whereas 14% did not (n = 594, median age 84 years) (for 2% the intent was uncertain). Patients treated with curative intent had a 5-year OS of 65.3% (95% CI: 63.7–66.9). The median OS among non-curatively treated patients was 2.9 months. The 5-year cumulative incidence of relapsed/refractory disease in curative patients was 23.1% (95% CI: 21.7–24.6, n = 847). The 2-year cumulative incidence of CNS relapse was 3.0% (95% CI: 2.5–3.6, n = 118) overall, and 8.0% (95% CI: 6.0–10.6, n = 48) among patients with high CNS-IPI (4–6), when considering other relapse locations and death as competing events. The incidence of relapsed/refractory DLBCL overall and in the CNS was lower than in previous reports, still one in seven patients was not considered fit enough to start standard immunochemotherapy at diagnosis. These results are important for quantification of groups of DLBCL patients with poor prognosis requiring completely different types of interventions.
 

摘要翻译： 

我们对瑞典2007–2014年间所有诊断为弥漫性大B细胞淋巴瘤（DLBCL）的患者进行了一项全国性人群队列研究，旨在评估治疗意向及复发/难治性疾病（包括中枢神经系统复发）的风险，并考虑了竞争风险因素。总体而言，84%的患者接受了以治愈为目的的治疗（基于蒽环类药物的方案）（n=3550，中位年龄69岁），而14%的患者未接受此类治疗（n=594，中位年龄84岁）（另有2%的患者治疗意向不明确）。接受治愈性治疗患者的5年总生存率为65.3%（95% CI: 63.7–66.9）。非治愈性治疗患者的中位总生存期为2.9个月。治愈性治疗患者中复发/难治性疾病的5年累积发生率为23.1%（95% CI: 21.7–24.6，n=847）。在将其他复发部位及死亡作为竞争事件的情况下，总体患者中2年中枢神经系统复发累积发生率为3.0%（95% CI: 2.5–3.6，n=118），而在高中枢神经系统国际预后指数（CNS-IPI 4–6）患者中该比率达8.0%（95% CI: 6.0–10.6，n=48）。DLBCL总体及中枢神经系统复发/难治性疾病的发生率低于既往报告，但仍有七分之一患者在确诊时身体状况被认为不适合启动标准免疫化疗。这些结果对于量化需要完全不同干预类型的DLBCL预后不良患者群体具有重要意义。

原文链接：

Incidence of relapsed/refractory diffuse large B-cell lymphoma (DLBCL) including CNS relapse in a population-based cohort of 4243 patients in Sweden