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在患有扩散性大B细胞淋巴瘤的老年患者中,R-miniCHOP与R-CHOP:一种倾向性匹配的基于人口的研究.

D Al-Sarayfi1, M Brink2, M E D Chamuleau3

  • 1Department of Hematology, University Medical Center Groningen, Groningen, The Netherlands.

American journal of hematology
|November 28, 2023
PubMed
概括

对于患有扩散性大B细胞淋巴瘤 (DLBCL) 的脆弱的老年患者,R-miniCHOP提供了一种可容忍的治疗方法. 然而,与R-CHOP相比,无进展生存率和整体生存率等生存结果较差,需要仔细选择患者.

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科学领域:

  • 在瘤学瘤学.
  • 血液学 血液学 血液学
  • 临床医学 临床医学

背景情况:

  • 扩散性大B细胞淋巴瘤 (DLBCL) 是一种常见的非霍奇金淋巴瘤.
  • 老年人和虚弱的患者通常需要修改治疗策略,因为伴随疾病和减少耐受性强化化疗法.
  • R-miniCHOP (利图西马布,环胺,多克索鲁比辛,温克里斯,普雷迪尼索隆) 作为脆弱的老年DLBCL患者的不那么密集的选择.

研究的目的:

  • 为了比较使用R-miniCHOP治疗的老年DLBCL患者的生存结果与标准R-CHOP.
  • 在现实环境中评估R-miniCHOP的有效性和安全性.

主要方法:

  • 对65岁及以上的DLBCL患者的回顾性分析,这些患者在2014-2020年期间在荷兰被诊断出患有DLBCL.
  • 倾向性得分匹配用于比较接受R-miniCHOP (n=384) 和R-CHOP (n=384) 治疗的患者.
  • 主要终点包括无进展生存率 (PFS),总生存率 (OS) 和相对生存率 (RS),随访至2022年.

主要成果:

  • 使用R-miniCHOP的比例从2014年的2%增加到2020年的15%.
  • 与R-miniCHOP相比,接受R-miniCHOP治疗的患者在两年内PFS (51%对68%),OS (60%对75%) 和RS (69%对86%) 显著低于R-CHOP.
  • 多变量分析显示,接受R-miniCHOP的患者有更高的全因死亡风险 (HR 1.73).

结论:

  • 虽然R-miniCHOP是许多老年DLBCL患者的有效选择,但与R-CHOP相比,它与较低的生存结果有关.
  • 越来越多地使用R-miniCHOP强调了在选择DLBCL的初始治疗时,需要仔细考虑个体患者的健康状况.