原発性骨髄リンパ腫のレトロスペクティブ分析：臨床的特徴と予後因子
Shuang Gao1, Lin Chen1, Su Liu1
1Department of Blood and Marrow Transplantation, Tianjin Cancer Hospital Airport Hospital, National Clinical Research Center for Cancer, Tianjin, 300308 China.
Objective:
The aim of this study is to investigate the status and significantly influencing factors of treatment and prognosis perceptions among primary bone marrow lymphoma (PBML) patients.
Methods:
We analyzed the clinical manifestations of 30 PBML patients with different treatment regimen and evaluated prognosis using the International Task Force Response Criteria for Malignant lymphoma to identify the major factors influencing prognosis and the best treatment for PBML.
Results:
In this retrospective cohort study of 30 newly diagnosed PBML patients, we demonstrated a significantly poorer prognosis compared to individuals with nodal malignant lymphoma. The median overall survival (OS) was 9 months and the median progression free survival (PFS) was 6.5 months. Univariate analysis identified subnormal platelet levels (P = 0.005) and failure to attain at least partial remission following four treatment cycles (P = 0.001) as significant predictors of unfavorable prognosis. Multivariate analysis demonstrated that remission status after four treatment cycles had prognostic significance. Patients who achieved complete remission had significantly longer median PFS and OS compared to those with partial remission (PFS: 34.5 months vs. 20.5 months; OS: 41.5 vs. 23 months). In patients with diffuse large B-cell lymphoma (DLBCL), the R-DA-EPOCH regimen demonstrated high efficacy; conversely, the R-CHOP protocol showed superior effectiveness in B-chronic lymphoproliferative disorder (B-CLPD) cases.
Conclusion:
PBML patients have a poor prognosis, and individual response to treatment may serve as a prognostic factor.
