贫血与弥漫大B细胞淋巴瘤病人的预后相关性

Correlation between anemia and the prognosis of patients with diffuse large B-cell lymphoma

目的研究贫血指标——血红蛋白(hemoglobin,Hb)与弥漫大B细胞淋巴瘤(diffuse large B?cell lymphoma,DLBCL)病人生存预后的关系。方法回顾性分析2014年6月至2018年3月在潍坊医学院附属医院(48例)和潍坊市人民医院(73例)确诊的共121例DLBCL病人的临床资料和随访资料。利用Kaplan?Meier法绘制生存曲线并计算生存率,利用对数秩检验比较不同等级Hb的DLBCL病人的单因素生存率。使用Cox比例风险回归模型进行影响DLBCL病人生存预后的单因素和多因素分析。结果Kaplan?Meier生存曲线显示,DLBCL病人1年和3年总生存率分别为87.42%、72.56%;1年和3年无进展生存率分别为80.07%、52.95%。多因素Cox比例风险回归分析发现如下因素均是影响DLBCL病人无进展生存期的预后危险因素:Ann Arbor分期(OR=3.376,95%CI:1.334~8.544)、骨髓浸润(OR=3.269,95%CI:1.231~8.160)、B症状(OR=2.213,95%CI:1.016~4.817)、Hb G2(100~80 g/L)(OR=4.261,95%CI:1.108~16.390)、Hb G3(<80 g/L)(OR=9.336,95%CI:2.475~35.219)。结论Ann Arbor分期、骨髓浸润、B症状、Hb≥G2(<100 g/L)与DLBCL病人的无进展生存期的预后存在关系;DLBCL病人初诊时的贫血程度愈深,无进展生存期愈短。

Objective To explore the relationship between the anemia index hemoglobin(Hb)and the survival and prognosis of diffuse large B?cell lymphoma(DLBCL)patients.Methods The retrospective analysis method was used to analyze the clinical da?ta and follow?up data of 121 DLBCL patients who had been diagnosed in The Affiliated Hospital of Weifang Medical College(48 cases)and Weifang People’s Hospital(73 cases)from June 2014 to March 2018.Kaplan?Meier method was used to draw the sur?vival curve and calculate the survival rate.Log?rank test was used to compare the single?factor survival rate of DLBCL patients with different grades of Hb.Cox proportional hazard regression model was used for univariate and multivariate analysis of survival and prognosis of patients with DLBCL.Results The Kaplan?Meier survival curves showed that the 1?year overall survival rate and the 3?year overall survival rate of DLBCL patients were 87.42%and 72.56%respectively;the 1?year progression?free survival rate and 3?year progression?free survival rate were 80.07%and 52.95%respectively.Multivariate Cox proportional risk regression analysis showed that Ann Arbor staging(OR=3.376,95%CI:1.334?8.544),bone marrow infiltration(OR=3.269,95%CI:1.231?8.160),B symptoms(OR=2.213,95%CI:1.016?4.817),Hb G2(100?80 g/L)(OR=4.261,95%CI:1.108?16.390),Hb G3(<80 g/L)(OR=9.336,95%CI:2.475?35.219)were risk factors for the prognosis of patients with DLBCL during progression free survival.Conclusions Ann Arbor staging,bone marrow infiltration,B symptoms,and Hb≥G2(<100 g/L)were associated with the progno?sis of patients who were diagnosed with DLBCL.The severer the degree of anemia at the time of initial diagnosis,the shorter the pro?gression free survive.