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
与鼻型结外 NK/T 细胞淋巴瘤或侵袭性 NK 细胞白血病相关的噬血细胞性淋巴组织细胞增生症：江苏省淋巴瘤协作组 (JCLG) 的多中心回顾性研究
英文原题：Hemophagocytic lymphohistiocytosis associated with extranodal NK/T cell lymphoma, nasal type or aggressive NK cell leukemia: a retrospective multicenter study of Jiangsu Cooperative Lymphoma Group (JCLG).
查看英文原题
Hemophagocytic lymphohistiocytosis associated with extranodal NK/T cell lymphoma, nasal type or aggressive NK cell leukemia: a retrospective multicenter study of Jiangsu Cooperative Lymphoma Group (JCLG).
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中文摘要
噬血细胞性淋巴组织细胞增多症（HLH）是一种危及生命的高炎症综合征，其中NK细胞恶性肿瘤相关HLH较为罕见，尚未得到系统研究。本项多中心回顾性队列研究分析了2010至2024年间136例成年NK细胞恶性肿瘤相关HLH患者数据。
结果显示，初始接受含依托泊苷的HLH治疗可改善60天生存率（P=0.009），但不影响总生存期（OS；P=0.306）；而对于既往未经治疗的患者，含门冬酰胺酶的淋巴瘤治疗方案可显著改善OS（P=0.025）和60天生存率（P=0.016）。多变量分析显示，60天结局不良的显著独立预测因素包括血清白蛋白<30 g/L（HR=2.03；95% CI 1.08–3.83；P=0.029）、血小板计数<20×10⁹/L（HR=2.70；95% CI 1.46–4.99；P=0.002）以及EB病毒DNA（全血）>33,850 copies/mL（HR=1.97；95% CI 1.01–3.81；P=0.045）。ECOG体能状态评分2分（HR=2.00；95% CI 1.24–3.23；P=0.004）和血小板计数<20×10⁹/L（HR=7.61；95% CI 2.14–27.09；P=0.002）是OS不良的独立危险因素。
因此，我们建议既往未经治疗的成年NK细胞恶性肿瘤相关HLH患者一线采用含门冬酰胺酶的方案。未来需要多中心前瞻性研究，以优化含门冬酰胺酶方案、评估新型联合策略，并建立精准风险预测模型指导临床实践。
展开英文摘要原文
Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening hyperinflammatory syndrome, among which NK-cell malignancy-associated HLH represents a clinically rare entity that has not been systematically investigated. The multicenter retrospective cohort study analyzed data from 136 adult patients diagnosed with HLH related to NK-cell malignancies between 2010 and 2024. The results demonstrated that initial treatment with etoposide-containing HLH therapy improved 60-day survival rates (P = 0. 009) but did not affect overall survival (OS) (P = 0. 306), whereas asparaginase-containing lymphoma regimens significantly improved both OS (P = 0.
025) and 60-day survival rates (P = 0. 016) in treatment-naive patients. By multivariate analysis, significant independent predictors of 60-day poor outcomes included serum albumin level < 30 g/L (HR, 2. 03; 95% CI, 1. 08-3. 83; P = 0. 029), platelet count < 20 10 /L (HR, 2. 70; 95% CI, 1. 46-4. 99; P = 0.
002), and Epstein-Barr virus DNA (whole blood) > 33,850 copies/mL (HR, 1. 97; 95% CI, 1. 01-3. 81; P = 0. 045). ECOG performance status 2 (HR, 2. 00; 95% CI, 1. 24-3. 23; P = 0. 004) and platelet count < 20 10 /L (HR, 7. 61; 95% CI, 2. 14-27. 09; P = 0. 002) were independent risk factors for poor OS.
Therefore, we recommend asparaginase-based regimens as first-line therapy for treatment-naive adult patients with HLH related to NK-cell malignancies. Future multicenter prospective studies are warranted to optimize asparaginase-containing regimens, evaluate novel combination strategies, and establish precision risk-prediction models to guide clinical practice.
论文信息
- 作者
- Li Y、Liu Y、Yang Y、Liang Z、Xia Y、Gao L、Zhou J、Li B
- 第一作者单位
- Department of Hematology, The First Affiliated Hospital with Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China.China
- 通讯作者单位
- Department of Hematology, The First Affiliated Hospital with Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China. miaoyi1992@hotmail.com.China
- 文献类型
- 多中心研究
- 期刊
- Annals of hematology2026 Jan 30
- 原文标识
- PubMed 41612048 · DOI 10.1007/s00277-026-06847-y
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