老年弥漫大B细胞淋巴瘤预后的相关影响因素探讨

doi:10.3969/j.issn.1671-7171.2017.02.004

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摘要【目的】探讨影响老年弥漫大B细胞淋巴瘤(DLBCL)患者的预后相关因素。【方法】通过分析2009年1月至2014年12月本院血液科收治的70例老年DLBCL患者的性别、年龄、Ann-Arbor分期、B症状、体能状态ECOG评分、血清乳酸脱氢酶(LDH)、国际预后评分指数(IPI)、骨髓浸润等临床资料,探讨上述指标与预后的相关性,并比较R-CHOP与CHOP两种方案患者的生存情况。【结果】70例老年DLBCL患者的中位生存期41.67个月,2年OS 率69.2%。单因素分析显示:年龄、Ann Arbor分期、ECOG 评分、IPI评分、治疗前LDH值、骨髓浸润、治疗方案均与预后有关(P<0.05);COX回归多因素分析表明:ECOG 评分、IPI评分、骨髓浸润、化疗方案是影响老年DLBCL患者预后的独立危险因素(P<0.01)。【结论】ECOG 评分、IPI评分、骨髓浸润、化疗方案是影响老年DLBCL患者预后的独立危险因素;R-CHOP方案较CHOP方案疗效好,能够改善患者生存。

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	赵淑清
	李军民
	徐子真
	杨晨敏

关键词 ：淋巴瘤, 大B细胞, 弥漫性, 预后, 危险因素, 老年人

Abstract：【Objective】To discuss the prognosis-related factors of elderly patients with diffuse large B-cell lymphoma (DLBCL). 【Methods】We retrospectively analyzed the clinical data from 70 cases of elderly patients with initial diffuse large B-cell lymphoma from January 2009 to December 2014. The parameters included gender, age, Ann-Arbor staging, B symptoms, ECOG score of performance status (ECOG-PS), serum level of lactate dehydrogenase (LDH), international prognostic index (IPI) and bone marrow invasion. We also compared the survival of patients who received CHOP chemotherapy and R-CHOP chemotherapy.The correlation between these indexes and prognosis was analyzed. 【Results】The median survival of all 70 cases of elderly patients with DLBCL was 41.67 months and the OS rate of 2 years was 69.2%. Single factor analysis showed that age, Ann-Arbor staging, bone marrow involvement, ECOG score, IPI score, value of LDH before treatment and therapeutic regimen were all related with prognosis (P<0.05 or P<0.01). COX regression multiple-factor analysis indicated that ECOG score、IPI score、bone marrow invasion and chemotherapy were the independent factors for predicting the prognosis of the elderly patients with DLBCL (P<0.01). 【Conclusion】ECOG score、IPI score、bone marrow invasion and chemotherapy were independent predictive and prognostic factors in elderly patients with DLBCL. R-CHOP chemotherapy has more advantages than CHOP chemotherapy in improving prognosis of elderly patients with DLBCL.

Key words： Lymphoma, Large B-Cell, Diffuse Prognosis Risk Factors Aged

收稿日期: 2016-01-18

PACS:

R733.41

基金资助:上海市卫计委青年科研基金项目(项目编号:2007Y67),上海市黄浦区卫计委优秀青年人才培养计划(2014-2016)

引用本文:

赵淑清;李军民;徐子真;杨晨敏. 老年弥漫大B细胞淋巴瘤预后的相关影响因素探讨[J]. 医学临床研究, 2017, 34(2): 219-222,225.
ZHAO Shu-qing; LI Jun-min; XU Zi-zhen,et al. Research on the Prognosis-related Factors of Elderly Patients with Diffuse Large B-cell Lymphoma. JOURNAL OF CLINICAL RESEARCH, 2017, 34(2): 219-222,225.

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http://www.jcr.net.cn/CN/10.3969/j.issn.1671-7171.2017.02.004 或 http://www.jcr.net.cn/CN/Y2017/V34/I2/219

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