CAR-T(CAR-T)细胞疗法在非肿瘤性疾病中的应用
Chimeric antigen receptor T (CAR-T) cell therapy in non-oncological diseases.
CAR-T(CAR-T)细胞在血液系统恶性肿瘤中的应用推动了这种免疫治疗形式的显著进展。
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题:Clinical Characteristics and Outcome of Diffuse Large B-Cell Lymphoma: Real-World Data From Saudi Arabia.
Clinical Characteristics and Outcome of Diffuse Large B-Cell Lymphoma: Real-World Data From Saudi Arabia.
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本研究为沙特阿拉伯 DLBCL 的临床现状提供了有价值的真实世界见解。总体结局与国际数据一致,尽管高龄和合并症仍与较差的预后相关。随着 CAR-T 细胞疗法和双特异性抗体等先进疗法的日益普及,预计生存率将进一步提高。这些发现强调需要建立国家淋巴瘤登记处,并持续投资于研究基础设施,以指导循证、个性化的诊疗。
弥漫大B细胞淋巴瘤(DLBCL)是全球及沙特阿拉伯最常见的非霍奇金淋巴瘤亚型。然而,关于其临床特征和结局的区域性数据仍然有限。
这项多中心回顾性队列研究纳入了2016年1月至2023年12月期间在沙特阿拉伯两家三级医院诊断为DLBCL的516例年龄≥14岁的患者。收集了人口统计学、疾病特征、治疗和结局的数据。使用Kaplan-Meier和Cox回归模型进行生存分析。
诊断时的中位年龄为60.5岁,53%的患者年龄小于65岁。大多数患者(77%)为晚期疾病。利妥昔单抗、环磷酰胺、多柔比星、长春新碱和泼尼松是最常用的一线方案,尤其是在年轻患者中(95% v 62%)。年轻患者(小于65岁)的完全缓解率为74%,65岁及以上患者为66%(P = .09)。复发/难治性疾病在老年患者中更常见(40% v 27%,P = .0019)。年轻患者的2年无进展生存率为78%,老年患者为64%(P = .004),而2年总生存期(OS)分别为87%和76%(P = .001)。年龄、体能状态、合并症、MYC表达和肾脏受累是OS的显著预测因素。
Diffuse large B-cell lymphoma (DLBCL) is the most common subtype of non-Hodgkin lymphoma worldwide and in Saudi Arabia. However, regional data on clinical characteristics and outcomes remain limited.
This multicenter retrospective cohort study included 516 patients age ≥14 years diagnosed with DLBCL between January 2016 and December 2023 at two tertiary hospitals in Saudi Arabia. Data on demographics, disease features, treatment, and outcomes were collected. Survival analysis was performed using Kaplan-Meier and Cox regression models.
The median age at diagnosis was 60.5 years, with 53% of patients younger than 65 years. Most patients (77%) had advanced-stage disease. Rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone was the most commonly used first-line regimen, particularly in younger patients (95% v 62%). Complete remission rates were 74% in patients younger than 65 years and 66% in those 65 years and older ( P = .09). Relapse or refractory disease occurred more frequently in older patients (40% v 27%, P = .0019). Two-year progression-free survival was 78% in younger patients and 64% in older patients ( P = .004), while 2-year overall survival (OS) was 87% and 76%, respectively ( P = .001). Age, performance status, comorbidities, MYC expression, and kidney involvement were significant predictors of OS.
This study provides valuable real-world insight into the clinical landscape of DLBCL in Saudi Arabia. Overall outcomes are consistent with international data, although older age and comorbidities remain associated with poorer prognosis. As advanced therapies such as chimeric antigen receptor T-cell therapy and bispecific antibodies become more available, further improvements in survival are expected. These findings underscore the need for a national lymphoma registry and continued investment in research infrastructure to guide evidence-based, personalized care.
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