Comparison of prognostic models for patients with early-stage diffuse large B-cell lymphoma

目的 探讨不同分层方法对早期弥漫大B细胞淋巴瘤(DLBCL)患者预后的价值.方法 回顾性分析2007年1月至2012年12月所诊断的97例初治Ⅰ/Ⅱ期DLBCL患者资料,所有患者至少接受2个周期R-CHOP(利妥昔单抗、环磷酰胺、多柔比星、长春新碱、泼尼松)方案免疫化疗.比较国际预后指数(IPI)、修订国际预后指数(R-IPI)、强化国际预后指数(NCCN-IPI)的预后价值.结果 97例患者中男50例,女47例,中位年龄58(15～88)岁.中位随访34.7(7.3～77.4)个月,全组患者的预计5年总生存(OS)率为82％.IPI分层中,低危、低中危和高中危组患者的5年OS率分别为95％、38％和60％(P＜0.001);R-IPI分层中,预后非常好、良好和差组患者的5年OS率分别为93％、75％和60％(P=0.226);NCCN-IPI分层中,低危、低中危和高中危组患者5年OS率分别为92％、85％和29％(P＜0.001).结论 NCCN-IPI是早期DLBCL患者的理想预后指标.Objective To compare the prognostic value of different models in patients with earlystage diffuse large B-cell lymphoma (DLBCL).Methods Early-stage DLBCL patients diagnosed from January 2000 to December 2012 were analyzed retrospectively.All patients received with at least 2 cycles of immunochemotherapy R-CHOP regimen (rituximab,cyclophosphamide,doxorubicin,vincristine,prednisone) with or without radiotherapy.The prognostic value of international prognostic index (IPI),revised IPI (R-IPI) and enhanced IPI (NCCN-IPI) was compared.Results Ninety-seven cases of earlystage DLBCL were included in the study.The median age was 58 years (15-88 years) with a median follow-up of 34.7 months (range 7.3-77.4 months).The expected 5-year overall survival (OS) for entire group was 82％.There was no patient in the high risk group according to IPI or NCCN-IPI.According to IPI,the 5-year OS in the low,low intermediate,high intermediate risk groups were 95％,38％ and 60％,respectively.According to R-IPI,the 5-year OS in the very good,good,and poor risk groups were 93％,75％ and 60％,respectively.According to NCCN-IPI,the 5-year OS in the low,low intermediate,high intermediate risk groups were 92％,85％ and 29％,respectively.Conclusion NCCN-IPI would be of an ideal prognostic model for early-stage DLBCL patients.PubMed中文核心期刊要目总览(PKU)中国科技核心期刊(ISTIC)中国科学引文数据库(CSCD)4269-2723