含BTK抑制剂的化疗方案治疗复发难治套细胞淋巴瘤的疗效及预后分析
Efficacy and Prognosis of Chemotherapy Regimen Containing BTK Inhibitor in Treatment of Recurrent/Refractory Mantle Cell Lymphoma
陈欢 1柳喜洋 1常宇 1陈子琪 1李文琪 1张蕾1
作者信息
- 1. 郑州大学第一附属医院肿瘤内科,河南郑州 450000
- 折叠
摘要
目的:观察含BTK抑制剂的化疗方案治疗复发难治套细胞淋巴瘤(MCL)的疗效及预后.方法:回顾性分析134例复发难治MCL患者的临床资料,观察患者临床特征,以及化疗方案对疗效、总生存(OS)率及无进展生存(PFS)率的影响.结果:患者中位年龄58(56-61)岁,男女比例约为2.9∶1,Ann Arbor分期Ⅲ-Ⅲ期患者占77.6％,结外受累部位＞2占43.3％,骨髓受累占60.4％,胃肠道受累占24.6％,肝脾肿大占38.1％.中位随访时间30(2-103)个月,总有效率41.8％,3年PFS未达到,3、5年OS率分别为62.7％、53.8％.含BTK抑制剂方案治疗组总有效率56.9％,优于不含BTK抑制剂方案治疗组的32.5％,比较差异有统计学意义(P=0.006),两组PFS率差异亦有统计学意义(P=0.002),而OS率差异无统计学意义(P＞0.05).经典型与特殊型之间PFS率差异无统计学意义(P＞0.05),而OS率差异有统计学意义(P＜0.001).Ki-67是复发难治MCL患者OS和PFS的影响因素.Ki-67、B症状、套细胞淋巴瘤国际预后指数评分、Ann Arbor分期是影响患者OS的独立预后因素.二线治疗方案是影响患者PFS的独立预后因素.结论:含BTK抑制剂方案治疗复发难治MCL有效率高,且可明显延长PFS,Ki-67、B症状、套细胞淋巴瘤国际预后指数评分、Ann Arbor分期为复发难治MCL的独立预后因素.
Abstract
Objective:To investigate the efficacy and prognosis of chemotherapy regimen containing Bruton's tyrosine kinase(BTK)inhibitor in the treatment of relapsed/refractory mantle cell lymphoma(R/R MCL).Methods:The clinical data of 134 patients with R/R MCL were collected and analyzed retrospectively.The clinical characteristics of patients and effect of chemotherapy regimen on efficacy,overall survival(OS)and progression-free survival(PFS)were observed.Results:The median age of the patients was 58(56-61)years old,and male to female ratio was about 2.9∶1.Patients with Ann Arbor stage Ⅲ-Ⅳ accounted for 77.6％,extranodal involvement＞2 for 43.3％,bone marrow involvement for 60.4％,gastrointestinal involvement for 24.6％,and hepatosplenomegaly for 38.1％.The median follow-up time was 30(2-103)months,overall response rate(ORR)was 41.8％,3-year PFS was not reached,and 3-year and 5-year OS rate was 62.7％and 53.8％,respectively.The ORR of BTK inhibitor group was 56.9％,which was higher than 32.5％of non-BTK inhibitor group(P=0.006).The difference was statistically significant in PFS between the two groups(P=0.002),but was not in OS(P＞0.05).The difference was statistically significant in OS between classical and special morphology(P＜0.001),but was not in PFS(P＞0.05).Ki-67 was an influencing factor for OS and PFS.Multivariate analysis showed that Ki-67,B symptoms,MIPI score,and Ann Arbor stage were independent prognostic factors affecting patients'OS.The second-line treatment regimen was an independent prognostic factor affecting patients'PFS.Conclusions:The chemotherapy regimen containing BTK inhibitors can effectively improve the efficacy and prolong the PFS of R/R MCL patients.Ki-67,B symptoms,MIPI score,and Ann Arbor stage are independent prognostic factors for R/R MCL patients.
关键词
BTK抑制剂/复发难治套细胞淋巴瘤/生存/预后Key words
BTK inhibitor/relapsed/refractory mantle cell lymphoma/survival/prognosis引用本文复制引用
基金项目
国家自然科学基金青年基金(82000204)
出版年
2024
NETL
NSTL
维普
万方数据