不适合移植的大 B 细胞淋巴瘤二线使用 axicabtagene ciloleucel：ALYCANTE 最终分析
Second-line axicabtagene ciloleucel in large B-cell lymphoma ineligible for transplantation: ALYCANTE final analysis.
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
早期化疗免疫治疗失败的弥漫大 B 细胞淋巴瘤的特征与预测模型
英文原题：Characteristics and predictive model for diffuse large B-cell lymphoma with early chemoimmunotherapy failure.
查看英文原题
Characteristics and predictive model for diffuse large B-cell lymphoma with early chemoimmunotherapy failure.
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研究概要
基于这些预测因子，我们建立了 ECF 列线图，并在中国患者队列及西方国家外部队列中验证了其良好的预测能力，表明我们的 ECF 预测模型在不同种族患者中均有效。该模型使临床医生能够早期识别 ECF 患者，优化治疗策略，并改善那些化疗耐药患者的预后。
研究思路结论见上方概要
背景
难治性或复发性弥漫大B细胞淋巴瘤的预后通常较差，尤其是那些在诊断后12个月内复发或进展的患者，被称为早期化学免疫治疗失败（ECF），其2年总生存率为24.7%。鉴于预后不良，早期识别ECF并开发针对性的创新治疗以改善患者预后显得尤为迫切。
方法
本研究自1997年12月至2020年12月，在上海瑞金医院及411医院招募了2038例新诊断的弥漫性大B细胞淋巴瘤（DLBCL）患者，这些患者接受了R-CHOP/RminiCHOP或基于R-CHOP的免疫化疗治疗。
结果
与对照组相比，ECF患者与高龄、晚期Ann Arbor分期、血清LDH升高、体能状态差、多部位结外受累、双表达淋巴瘤（DEL）及非GCB亚型，以及TP53、FOXO1和FBXW7突变的高频率显著相关。通过多变量分析，高龄、晚期分期、血清LDH升高、DEL及TP53或FOXO1突变是ECF的独立预测因素。
展开英文摘要原文
METHODS
This study recruited 2038 newly diagnosed DLBCL patients treated with R-CHOP/RminiCHOP or R-CHOP-based immunochemotherapy in Ruijin hospital and 411 hospital from December 1997 to December 2020.
RESULTS
Compared to the control group, ECF patients were significantly associated with elderly age, advanced Ann Arbor stage, elevated serum LDH, poor performance status, multiple extranodal involvements, double expressor lymphoma (DEL), and non-GCB subtype, as well as high frequencies of TP53 , FOXO1 and FBXW7 mutations. Through multivariate analysis, elderly age, advanced stage, elevated serum LDH, DEL, and mutations of TP53 or FOXO1 were independent predictors of ECF. DISCUSSION: Based on these predictors, a nomogram of ECF was established, and the straining cohort of our Chinese patients as well as the external cohort from Western countries showed a good predictive power of the ECF model, indicating the efficiency of our ECF predicting model, regardless of patients' race. Our ECF model allows clinicians to early recognize ECF patients, to optimize the therapeutic strategies and to improve the outcome of those chemo-resistant patients.
论文信息
- 作者
- Dong YY、Shi Q、Wu W、Zhao BB、Fu D、Xu PP、Cheng S、Bousquet G
- 单位
- Shanghai Institute of Hematology, State Key Laboratory of Medical Genomics; National Research Center for Translational Medicine at Shanghai, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.China
- 期刊
- Frontiers in immunology2025
- 原文标识
- PubMed 40589747 · DOI 10.3389/fimmu.2025.1553850
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