文章：

结节性淋巴细胞为主型霍奇金淋巴瘤的转归与结局：一项基于芬兰全国人群的研究

Transformation and outcome of nodular lymphocyte predominant Hodgkin lymphoma: a Finnish Nationwide population-based study

原文发布日期：2021-12-18

DOI: 10.1038/s41408-021-00586-1

类型: Article

开放获取: 是

英文摘要：

Nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) is a rare B-cell malignancy associated with excellent survival. However, some patients experience histological transformation into aggressive large B-cell lymphoma. Population-based data on transformation in patients with NLPHL is limited. We conducted a nationwide population-based study to estimate the risk of transformation and relative survival in patients diagnosed with NLPHL in Finland between 1995 and 2018. We identified a total of 453 patients (median age, 48 years; 76% males) with the incident NLPHL from the Finnish Cancer Registry. The cumulative incidence of transformation was 6.3% (95% CI, 4.2-9.6) at 10 years. After adjusting for sex, age and year of diagnosis, transformation was associated with a substantially increased risk of death (HR 8.55, 95% CI 4.49−16.3). Ten-year relative survival was 94% (95% CI, 89%‒100%). The patients diagnosed at a later calendar year had lower excess risk of death (HR, 0.38 per 10-year increase; 95% CI, 0.15‒0.98). We conclude that while the 10-year relative survival for the patients with NLPHL was excellent in this large population-based cohort for the entire study period, transformation resulted in a substantially increased mortality compared with the patients without transformation. Our results also suggest a reduction in excess mortality over time.
 

摘要翻译： 

有证据表明，血液恶性肿瘤患者对SARS-CoV-2疫苗的有效性降低。我们推测，肿瘤及相关治疗导致的免疫抑制可通过外周血呈现，且疫苗接种前的免疫特征分析有助于预测免疫原性。我们对83例血液病患者在接种前进行了全面的免疫学特征分析，并利用多维计算流式细胞术检测了他们在完成第二剂COVID-19疫苗接种后第7天对四种病毒抗原的IgM、IgG及IgA抗体反应。同年龄段的医疗工作者作为对照组（102例）。结果显示，患者体内59种免疫细胞类型中有44种发生显著改变；其中单克隆丙种球蛋白病患者的免疫抑制程度高于B细胞疾病和霍奇金淋巴瘤患者。免疫失调在治疗前已出现，治疗期间达到高峰，且在停止治疗后未能恢复正常。我们鉴定出一种与弱抗体反应显著相关的免疫类型，并发现中性粒细胞、经典单核细胞、CD4和CD8效应记忆性CD127低表达T细胞，以及初始CD21阳性B细胞和IgM阳性D阳性记忆B细胞的频率与免疫原性独立相关。因此，我们提出了新的免疫生物标志物，可用于预测血液病患者对COVID-19疫苗的有效反应，这些标志物与治疗相关因素互为补充，有助于为可能的疫苗加强接种方案提供个性化参考。

原文链接：

Transformation and outcome of nodular lymphocyte predominant Hodgkin lymphoma: a Finnish Nationwide population-based study