摘要
目的:探讨老年弥漫性大B细胞淋巴瘤(DLBCL)患者的临床特征和预后影响因素。方法:收集SEER数据库中2010至2015年期间经病理诊断的老年弥漫性大B细胞淋巴瘤患者的临床特征资料,采用Cox比例风险模型进行分析,应用Kaplan-Meier法绘制生存曲线,探究影响总生存期的预后因素。结果:共纳入老年DLBCL患者11523例,其中Ⅲ/Ⅳ期患者占58.6%,结外侵犯患者占28.8%,原发病灶除淋巴结(68.5%)外,结外原发多位于胃肠道(9.8%)及唇、口腔和咽部(4.1%)等部位。整个队列中位生存时间为47个月,3年生存率为52.0%,5年生存率为47.8%。多因素Cox回归分析显示,年龄、性别、种族、Ann Arbor分期、原发部位、B症状、治疗方式、治疗顺序和DLBCL是否为第一原发恶性肿瘤是影响老年DLBCL患者OS的独立预后因素(P<0.05)。结论:年龄≥70岁,男性,黑人种族,Ann Arbor分期高,原发部位位于肺、肝和肾脏,存在B症状和术前接受全身治疗是老年DLBCL预后不良的独立危险因素。
Objective:To investigate the clinical characteristics and prognostic factors of elderly patients with diffuse large B-cell lymphoma(DLBCL).Methods:Clinical data of elderly DLBCL patients diagnosed pathologically between 2010 and 2015 were extracted from the SEER database.Cox proportional hazards model was used for multivariate analysis,and Kaplan-Meier survival curves were plotted to explore the prognostic factors affecting overall survival(OS).Results:A total of 11523 elderly DLBCL patients were included,of whom 58.6%had stageⅢ/Ⅳdisease,and 28.8%exhibited extranodal involvement.Besides lymph nodes(68.5%),common primary extranodal sites included the gastrointestinal tract(9.8%)and lip,mouth,and pharynx(4.1%).The median survival time for the entire cohort was 47 months,with a 3-year survival rate of 52.0%,and a 5-year survival rate of 47.8%.Multivariate Cox regression analysis revealed that age,sex,race,Ann Arbor stage,primary site,B symptoms,treatment modality,treatment sequence,and whether DLBCL was the first malignant primary indicator were independent prognostic factors affecting OS in elderly DLBCL patients(all P<0.05).Conclusion:Age≥70 years,male,black race,advanced Ann Arbor stage,primary sites in the lungs,liver,or kidney,presence of B symptoms,and preoperative systemic therapy were independent risk factors for poor prognosis in elderly DLBCL patients.
作者
楚立园
张丁丹
张雅月
范秋月
田劭丹
CHU Li-Yuan;ZHANG Ding-Dan;ZHANG Ya-Yue;FAN Qiu-Yue;TIAN Shao-Dan(Department of Hematology and Oncology,Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China)
出处
《中国实验血液学杂志》
北大核心
2025年第5期1327-1334,共8页
Journal of Experimental Hematology
基金
国家科技重大专项项目—重大新药创制专项(2019ZX09201004-002-001)
国家中医药管理局高水平中医药重点学科建设项目中医血液病学(zyyzdxk—2023268)。
关键词
老年弥漫性大B细胞淋巴瘤
预后因素
生存分析
临床特征
diffuse large B-cell lymphoma in the elderly
prognostic factors
survival analysis
clinical features
作者简介
通信作者:田劭丹,主任医师,博士研究生导师.E-mail:oliviatsd@126.com。
