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本研究回顾性分析经正规R-CHOP方案治疗弥漫大B细胞淋巴瘤(DLBCL)患者的生存状况,探讨自体造血干细胞移植(auto-HSCT)、病理类型、国际预后指数(IPI)等因素对预后的影响。收集2004-2011年在本院接受R-CHOP21≥6次化疗的DLBCL患者116例。分析单纯化疗及化疗联合自体造血干细胞移植取得的疗效,以及不同免疫病理类型、临床观察指标如IPI、超敏C反应蛋白(HSCRP)、a-羟丁酸脱氨酶(HBDH)等因素对DLBCL患者预后的影响,包括对总体生存率(OS)、无进展生存率(PFS)的系统观察。结果表明,接受R-CHOP21方案治疗的116例DLBCL患者5年OS为72.4%,其中30例患者接受自体造血干细胞移植(Ann Arbor分期均为Ⅲ-Ⅳ期)。30例移植组患者预后较86例单纯化疗组好(5年OS为82.5%vs 69.0%,5年PFS为77.1%vs 68.3%)(P<0.05);生发中心(GCB)型组患者预后较活化亚型(ABC)组好(P<0.05);IPI 3-5分、年龄≥60岁、B症状、LDH升高、HSCRP升高、HBDH升高是预后不良因素(P<0.05),其中LDH升高、年龄≥60岁、B症状是本研究患者的独立危险因素(P<0.05)。结论:自体造血干细胞移植联合R-CHOP治疗方案能明显改善DLBCL患者的预后,GCB型患者预后优于ABC型,B症状、IPI评分、LDH、HSCRP、HBDH是预后的影响因素。
This study retrospectively analyzed the survival of patients with diffuse large B-cell lymphoma (DLBCL) treated with formal R-CHOP regimen and explored the prognostic value of auto-HSCT, pathological type and International Prognostic Index (IPI) Impact. A total of 116 DLBCL patients receiving R-CHOP21 ≥6 chemotherapy in our hospital from 2004 to 2011 were collected. To analyze the curative effect of simple chemotherapy and chemotherapy combined with autologous hematopoietic stem cell transplantation, and to investigate the effect of different immunopathological types, clinical observation indexes such as IPI, HSCRP and a-hydroxybutyrate deaminase (HBDH) The impact of patient outcomes, including systematic observation of overall survival (OS) and progression-free survival (PFS). The results showed that the 5-year OS of 116 DLBCL patients treated with R-CHOP21 regimen was 72.4%. Thirty patients received autologous stem cell transplantation (Ann Arbor stage Ⅲ-Ⅳ). The prognosis of the 30 patients in the germinal center (GCB) group was better than that in 86 patients (82.5% vs 69.0% in 5 years and 77.1% vs 68.3% in 5 years) (P <0.05) (P <0.05); IPI 3-5 points, age ≥ 60 years old, B symptoms, LDH increased, HSCRP increased, HBDH increased is a poor prognostic factor (P <0.05), of which LDH increased, age ≥ 60 years old, B symptoms were independent risk factors in this study (P <0.05). CONCLUSION: Autologous hematopoietic stem cell transplantation combined with R-CHOP treatment can significantly improve the prognosis of patients with DLBCL. The prognosis of GCB patients is better than that of ABC type, B symptoms, IPI score, LDH, HSCRP and HBDH.