中枢神经系统预防方法在高风险的扩散性大B细胞淋巴瘤患者:一个追溯收集,单中心队列分析
Yanli Wang1, Xiaolian Wen1, Tao Guan1
1Shanxi Medical University Affiliated Cancer Hospital/Shanxi Provincial Cancer Hospital/Chinese Academy of Medical Sciences Cancer Hospital Affiliated Shanxi Hospital, Hematology Department, Taiyuan, China.
Cancer medicine
|April 1, 2025
概括
高剂量甲状腺素 (HD-MTX) 可能有助于预防分散型大B细胞淋巴瘤 (DLBCL) 患者中中枢神经系统 (CNS) 复发. 虽然没有得到确定的证据,但年轻的患者和风险较低的患者显示出潜在的益处,并能很好地容忍治疗.
科学领域:
- 在瘤学瘤学.
- 血液学 血液学 血液学
- 临床研究 临床研究
背景情况:
- 扩散性大B细胞淋巴瘤 (DLBCL) 存在中枢神经系统 (CNS) 复发的风险.
- 预防中枢神经系统复发对于改善DLBCL患者的治疗结果至关重要.
研究的目的:
- 评估静脉注射高剂量甲状腺素 (HD-MTX) 在新诊断的高风险DLBCL患者中预防中枢神经系统复发的疗效.
- 评估HD-MTX对无进展生存 (PFS),总生存 (OS) 和治疗毒性的影响.
主要方法:
- 对136名新诊断的高风险DLBCL患者的回顾性分析.
- 接受HD-MTX的组与不接受HD-MTX的对照组之间的比较.
- 主要终点:中枢神经系统复发率,PFS,OS和毒性.
主要成果:
- 2年的中枢神经系统复发率为4.3% (HD-MTX组) 和11.1% (非HD-MTX组) (p=0.337).
- 在HD-MTX组显示显著改善2年的PFS (70.7%对60.8%,p=0.013) 和OS (72.9%对60.8%,p=0.024).
- 亚组分析表明,对年轻患者和具有低/中等NCCN-IPI风险评分的患者有好处;毒性在各组之间是可比的.
结论:
- 由于证据有限,该研究无法最终确定HD-MTX在预防中枢神经系统复发中的作用.
- 年轻患者和低/中等NCCN-IPI风险患者可以耐受HD-MTX,这表明对预防中枢神经系统复发的潜在有效性,特别是当在R-CHOP的第6天服用时.
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