2000-2020年瑞典的脏边缘区域淋巴瘤:老年人里图西马布使用量的增加和更好的生存率
Henna-Riikka Junlén1,2, Kristina Sonnevi1,2, Ola Lindén3
1Division of Hematology Department of Medicine Huddinge Karolinska Institutet Stockholm Sweden.
EJHaem
|August 21, 2023
概括
等待和观察是无症状脏边缘区域淋巴瘤 (SMZL) 的合理选择. 症状患者受益于单剂瑞图西马布,表现出与脊髓切除术或化疗相似的存活率.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 临床医学 临床医学
背景情况:
- 脊髓边缘区域淋巴瘤 (SMZL) 的治疗仍在争论中.
- 骨切除术是历史上的标准,但像Rituximab这样的新疗法正在出现.
- 对SMZL的最佳预先治疗策略需要进一步研究.
研究的目的:
- 为了比较脏边缘区域淋巴瘤的不同前期治疗策略的有效性.
- 评估SMZL临床特征的预后意义.
- 根据最初的治疗选择,评估长期生存结果.
主要方法:
- 在瑞典诊断的358名SMZL患者 (2000-2020年) 的基于人口的队列研究.
- 基于初始治疗的整体存活率分析:等待和观察,rituximab单疗法,rituximab化疗,脊髓切除术,化疗或组合疗法.
- 多变量分析以确定独立的预后因素.
主要成果:
- 平均总生存时间为11.0年;年龄是唯一独立的预后因素.
- 化疗导致较低的生存率与rituximab,rituximab-化疗和脊髓切除术相比.
- 在年龄调整后,等待和观察,脊髓切除术和基于Rituximab的疗法之间的生存率是可比的.
- 增加rituximab的使用与老年患者 (≥73岁) 的生存率改善相关.
结论:
- 等待和观察是适合无症状SMZL患者的初始方法.
- 建议使用单剂利图西马布作为症状性SMZL的第一线治疗.
- 这些发现支持基于患者症状和年龄的个性化治疗方法.
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