原发性纵隔大B细胞淋巴瘤(primary mediastinal large B-cell lymphoma,PMBCL)是弥漫性大B细胞淋巴瘤(diffuse large B-cell lymphoma,DLBCL)的一种特殊亚型,好发于年轻女性[1-2]。PMBCL是一种罕见的癌症,目前对复发/难治性PMBCL的治疗...原发性纵隔大B细胞淋巴瘤(primary mediastinal large B-cell lymphoma,PMBCL)是弥漫性大B细胞淋巴瘤(diffuse large B-cell lymphoma,DLBCL)的一种特殊亚型,好发于年轻女性[1-2]。PMBCL是一种罕见的癌症,目前对复发/难治性PMBCL的治疗一般与其他复发/难治性DLBCL治疗相同,治疗方案主要包括:R-DA-EPOCH(利妥昔单抗+依托泊苷+泼尼松+长春新碱+环磷酰胺+阿霉素),DHAP(地塞米松+阿糖胞苷+顺铂),ESHAP(依托泊苷+甲基强的松+阿糖胞苷+铂剂),GDP(吉西他滨+地塞米松+顺铂),以及mini-beam(卡莫司汀+依托泊苷+阿糖胞苷+马法兰)[3-4]。展开更多
Background: To compare the efficacy and safety of dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin plus rituximab (DA-EPOCH-R) with standard rituximab, cyclophosphamide, doxorubicin,...Background: To compare the efficacy and safety of dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin plus rituximab (DA-EPOCH-R) with standard rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) in Waldeyer’s ring diffuse large B-cell lymphoma (WR-DLBCL) at a single institution. Methods: This retrospective study included 115 newly diagnosed patients with WR-DLBCL, of whom 68 patients received R-CHOP, and 47 patients received DA-EPOCH-R as their first-line treatment. The baseline features of the two groups were well balanced using a 1:1 propensity score matching method, and a total of 84 cases were obtained, including respective 42 cases in the R-CHOP and DA-EPOCH-R groups, for further survival and prognosis analysis. The primary objectives included progression-free survival (PFS) and overall survival (OS). Results: During a median follow-up of 45 months, there were nine (21.4%) deaths in the R-CHOP group and two (4.8%) in the DA-EPOCH-R group. Kaplan-Meier analysis showed statistically significant improvements in PFS and OS in patients with DA-EPOCH-R compared with those treated with R-CHOP (log-rank test, P = 0.025 and P = 0.035, respectively). The 2-year PFS and OS rates in the DA-EPOCH-R group were 90.1% (95% confidence interval [CI]: 81.4-99.8%) and 95.2% (95% CI: 89.0-100.0%), respectively, and 80.5% (95% CI: 69.3-93.6%) and 90.5% (95% CI: 52.8-99.8%) in the R-CHOP group. Patients without B symptoms and elevated lactate dehydrogenase levels had a higher PFS in the DA-EPOCH-R group, with P values of 0.038 (hazard ratio [HR]: 0.11;95% CI: 0.01-0.88) and 0.042 (HR: 0.19;95% CI: 0.04-0.94), respectively. There were no statistically significant differences in clinical responses and treatment-related toxicities between the two groups. Conclusion: Compared with patients received R-CHOP, those treated by DA-EPOCH-R had superior PFS, OS, and controlled toxicity in patients with WR-DLBCL.展开更多
文摘原发性纵隔大B细胞淋巴瘤(primary mediastinal large B-cell lymphoma,PMBCL)是弥漫性大B细胞淋巴瘤(diffuse large B-cell lymphoma,DLBCL)的一种特殊亚型,好发于年轻女性[1-2]。PMBCL是一种罕见的癌症,目前对复发/难治性PMBCL的治疗一般与其他复发/难治性DLBCL治疗相同,治疗方案主要包括:R-DA-EPOCH(利妥昔单抗+依托泊苷+泼尼松+长春新碱+环磷酰胺+阿霉素),DHAP(地塞米松+阿糖胞苷+顺铂),ESHAP(依托泊苷+甲基强的松+阿糖胞苷+铂剂),GDP(吉西他滨+地塞米松+顺铂),以及mini-beam(卡莫司汀+依托泊苷+阿糖胞苷+马法兰)[3-4]。
基金financially supported by the National Natural Science Foundation of China(Nos.81873450 and 82170181)the Beijing Municipal Administration of Hospitals’Youth Program(No.QMS20200201).
文摘Background: To compare the efficacy and safety of dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin plus rituximab (DA-EPOCH-R) with standard rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) in Waldeyer’s ring diffuse large B-cell lymphoma (WR-DLBCL) at a single institution. Methods: This retrospective study included 115 newly diagnosed patients with WR-DLBCL, of whom 68 patients received R-CHOP, and 47 patients received DA-EPOCH-R as their first-line treatment. The baseline features of the two groups were well balanced using a 1:1 propensity score matching method, and a total of 84 cases were obtained, including respective 42 cases in the R-CHOP and DA-EPOCH-R groups, for further survival and prognosis analysis. The primary objectives included progression-free survival (PFS) and overall survival (OS). Results: During a median follow-up of 45 months, there were nine (21.4%) deaths in the R-CHOP group and two (4.8%) in the DA-EPOCH-R group. Kaplan-Meier analysis showed statistically significant improvements in PFS and OS in patients with DA-EPOCH-R compared with those treated with R-CHOP (log-rank test, P = 0.025 and P = 0.035, respectively). The 2-year PFS and OS rates in the DA-EPOCH-R group were 90.1% (95% confidence interval [CI]: 81.4-99.8%) and 95.2% (95% CI: 89.0-100.0%), respectively, and 80.5% (95% CI: 69.3-93.6%) and 90.5% (95% CI: 52.8-99.8%) in the R-CHOP group. Patients without B symptoms and elevated lactate dehydrogenase levels had a higher PFS in the DA-EPOCH-R group, with P values of 0.038 (hazard ratio [HR]: 0.11;95% CI: 0.01-0.88) and 0.042 (HR: 0.19;95% CI: 0.04-0.94), respectively. There were no statistically significant differences in clinical responses and treatment-related toxicities between the two groups. Conclusion: Compared with patients received R-CHOP, those treated by DA-EPOCH-R had superior PFS, OS, and controlled toxicity in patients with WR-DLBCL.
