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
英文原题:Prognostic Value of C-Reactive Protein/Platelet Ratio as a Biomarker Prior to Allogeneic Hematopoietic Stem Cell Transplantation in Malignant Lymphoma.
Prognostic Value of C-Reactive Protein/Platelet Ratio as a Biomarker Prior to Allogeneic Hematopoietic Stem Cell Transplantation in Malignant Lymphoma.
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既往研究显示,移植前C反应蛋白(CRP)/血小板比值(CP比值)可预测生存。本多中心回顾性研究旨在评估CP比值对接受异基因造血干细胞移植(alloHCT)的恶性淋巴瘤(ML)患者的临床意义。队列纳入2007年至2021年首次接受alloHCT的ML患者。移植前定义并评估CP比值:CRP [mg/dL]/血小板[10^4/μL]。根据既往研究,将CP比值截断值设为0.05。共分析311例,其中成熟B细胞淋巴瘤134例、T/NK细胞淋巴瘤177例(包括成人T细胞白血病/淋巴瘤70例)和霍奇金淋巴瘤17例。中位年龄为53岁(范围:17–69岁)。
高CP比值与疾病状态、感染、移植时体能状态较差以及移植前输血量较高相关。按CP比值低组与高组分层,两年总生存率(OS)分别为61.1%和30.1%(p<0.001),非复发死亡率(NRM)分别为21.4%和40.7%(p=0.001),复发率分别为23.7%和32.6%(p=0.061)。多变量分析显示,高CP比值组与较差OS(HR=2.20,95% CI:1.61–3.02,p<0.001)及较高NRM(HR=1.90,95% CI:1.28–2.81,p=0.0014)相关。高CP比值与移植后OS较差及NRM较高相关,可作为适用于alloHCT候选ML患者风险分层的预后生物标志物。
Previous studies have shown that the pre-transplant C-reactive protein (CRP)/platelet ratio (CP ratio) is a predictor of survival. The aim of this multicenter retrospective study was to evaluate the clinical significance of CP ratio in patients with malignant lymphoma (ML) who underwent allogeneic hematopoietic stem cell transplantation (alloHCT). The cohort included patients with ML who underwent first alloHCT from 2007 to 2021. CP ratio was defined as CRP [mg/dL]/platelet [10 4/ L] and evaluated prior to alloHCT.
The cutoff value for CP ratio was set at 0. 05 based on previous studies. A total of 311 cases were analyzed, of which 134 were mature B cell lymphoma, 177 were T/NK cell lymphoma (including 70 cases of adult T-cell leukemia/lymphoma), and 17 were Hodgkin's lymphoma. The median age was 53 years (range: 17-69 years). High CP ratio was associated with status of disease, presence of infections, poor performance status at alloHCT, and high transfusion volume received prior to alloHCT.
Overall survival (OS) at 2 years according to CP ratio (low vs. high) was 61. 1% versus 30. 1% (p < 0. 001), non-relapse mortality (NRM) was 21. 4% versus 40. 7% (p = 0. 001), and the relapse rate was 23. 7% versus 32. 6% (p = 0. 061), respectively. In multivariate analysis, the high CP ratio group was associated with poor OS (HR = 2.
20, 95% CI: 1. 61-3. 02, p < 0. 001) and higher NRM (HR = 1. 90, 95% CI: 1. 28-2. 81, p = 0. 0014). High CP ratio was found to be associated with poor post-transplant OS and NRM, and was a suitable prognostic biomarker for stratifying the risk of patients with ML who are candidates for alloHCT.
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