摘要
目的分析老年(≥65岁)套细胞淋巴瘤(MCL)患者的临床特征和预后影响因素,探讨基础营养和疾病状态对老年MCL患者预后的影响。方法回顾性分析2000年1月至2021年2月在北京大学第三医院等11个中心收治的255例老年MCL患者的临床资料,主要指标包括年龄、性别、MIPI评分、治疗方案及疗效,采用Kaplan-Meier法和Cox回归模型进行预后的单因素及多因素分析;对50例有白蛋白水平及基础疾病资料的老年MCL患者进行老年综合疾病评估,分析老年患者基础疾病和基础营养状态,以及老年综合疾病状态对预后的影响。结果在纳入的795例MCL患者中,老年MCL患者255例(32.1%)。老年MCL好发于男性(78.4%),中位年龄69(65~88)岁,初诊时多为晚期(88.6%)。老年MCL患者的治疗总有效率为77.3%,完全缓解率为33.3%。3年总生存(OS)率为42.0%,3年无进展生存(PFS)率为21.2%。老年MCL患者相较年轻患者更易合并高血压等慢性基础疾病。多因素分析结果显示,与PFS期相关的独立预后不良因素包括高龄(P=0.021)、Ann Arbor分期Ⅲ~Ⅳ期(P=0.003)、高LDH水平(P=0.003)、骨髓受累(P=0.014);与OS期相关的独立预后不良因素包括高龄(P=0.001)、高LDH水平(P=0.003)。老年综合疾病评估提示肾功能不全为与OS相关的预后不良因素(P=0.047)。结论老年MCL患者合并基础疾病更多;高龄、高LDH水平、肾功能不全、骨髓受累、Ann Arbor分期Ⅲ~Ⅳ期为老年MCL患者预后的独立危险因素。
Objective To examine the clinical characteristics and prognostic factors of elderly patients with mantle cell lymphoma(MCL)and the impact of nutrition and underlying diseases on the prognosis of elderly patients with MCL.Methodsretrospectively analyzed 255 elderly patients with MCL from 11 medical centers,including Peking University Third Hospital between January 2000 and February 2021.We analyzed clinical data,such as age,gender,Mantle Cell Lymphoma International Prognostic Index score,and treatment options,and performed univariate and multivariate prognostic analysis.We performed a comprehensive geriatric assessment on elderly MCL patients with medical records that included retraceable underlying disease and albumin levels,and we investigated the impact of basic nutrition and underlying disorders on MCL prognosis in the elderly.ResultsThere were 255 senior individuals among the 795 MCL patients.Elderly MCL was more common in males(78.4%),with a median age of 69 yr(ages 65-88),and the majority(88.6%)were identified at a late stage.The 3-yr overall survival(OS)rate was 42.0%,with a 21.2%progression-free survival(PFS)rate.The overall response rate(ORR)was 77.3%,with a 33.3%total remission rate.Elderly patients were more likely than younger patients to have persistent underlying illnesses,such as hypertension.Multivariate analysis revealed that variables related with poor PFS included age of≥80(P=0.021),Ann Arbor stageⅢ-Ⅳ(P=0.003),high LDH level(P=0.003),involvement of bone marrow(P=0.014).Age of≥80(P=0.001)and a high LDH level(P=0.003)were risk factors for OS.The complete geriatric assessment revealed that renal deficiency was associated with poorer OS(P=0.047).ConclusionsElderly MCL patients had greater comorbidities.Age,LDH,renal function,bone marrow involvement,and Ann Arbor stage are all independent risk factors for MCL in the elderly.
作者
郝晓宇
杨萍
张薇
刘辉
孙秀华
肖秀斌
王景文
李振玲
李利红
王树叶
何娟
李晓玲
景红梅
Hao Xiaoyu;Yang Ping;Zhang Wei;Liu Hui;Sun Xiuhua;Xiao Xiubin;Wang Jingwen;Li Zhenling;Li Lihong;Wang Shuye;He Juan;Li Xiaoling;Jing Hongmei(Peking University Third Hospital,Beijing 100191,China;Peking Union Medical College Hospital,Beijing 100730,China;Beijing Hospital,Beijing 100730,China;The Second Hospital of Dalian Medical University,Dalian 116027,China;The 5th Medical Center of PLA General Hospital,Beijing 100039,China;Beijing Tongren Hospital,Beijing 100730,China;China-Japan Friendship Hospital,Beijing 100029,China;Beijing Tsinghua Changgung Hospital,Beijing 102218,China;The First Hospital of Harbin Medical University,Harbin 150001,China;The First Hospital of China Medical University,Shenyang 110001,China;Liaoning Cancer Hospital&Institute,Shenyang 110042,China)
出处
《中华血液学杂志》
CAS
CSCD
北大核心
2023年第6期495-500,共6页
Chinese Journal of Hematology
关键词
套细胞淋巴瘤
老年
临床特点
预后
Mantle cell lymphoma
Elderly
Clinical features
Prognosis
作者简介
通信作者:景红梅,Email:hongmeijing@bjmu.edu.cn。
