摘要
目的:分析恶病质指数(cachexia index,CXI)对R-CHOP治疗的弥漫性大B细胞淋巴瘤(diffuse large B-cell lymphoma,DLBCL)患者预后的评价。方法:回顾性分析2020年1月—2022年1月接受R-CHOP治疗的DLBCL患者80例,收集患者相关资料并计算CXI值,根据CXI中位数将患者分为低CXI组和高CXI组,比较2组临床资料、治疗反应、无进展生存期(PFS)、总生存期(OS)和治疗相关毒性。结果:CXI中位数男性为42.61,女性为25.28,高CXI组43例,低CXI组37例。低CXI组年龄>60岁患者、ECOG PS 2~3分、B症状、Ann ArborⅢ~Ⅳ级、LDH异常、IPI高中危和高危比例均高于高CXI组,差异有统计学意义(P<0.05)。低CXI组所有患者CR低于高CXI组,疾病进展例数高于高CXI组(P<0.05)。高CXI患者PFS和OS高于低CXI患者(P<0.05)。多变量分析表明,BMI<18.5、IPI高中危和高危以及低CXI是PFS和OS的独立预后指标(P<0.05)。高CXI组3~4级贫血、血小板减少和发热性中性粒细胞减少发生率,以及3级或以上的非血液毒性均低于低CXI组(P<0.05)。低CXI组早期治疗中断例数高于高CXI组(P<0.05)。结论:CXI是一种有效的癌症恶病质生物标志物,可以预测DLBCL患者的生存率、治疗反应和治疗相关毒性。
Objective To analyze the evaluation of cachexia index(CXI)on the prognosis of patients with diffuse large B-cell lymphoma(DLBCL)treated with R-CHOP.Methods A retrospective analysis was conducted on 80 DLBCL patients treated with R-CHOP from January 2020 to January 2022.Patient data and calculate CXI values were collected.Patients were divided into low CXI group and high CXI group according to the median CXI.Clinical data,treatment response,progression-free survival(PFS),overall survival(OS)and treatment-related toxicity were compared between the two groups.Results The median CXI was 42.61 for males and 25.28 for females,with 43 cases in the high CXI group and 37 cases in the low CXI group.The low CXI group's proportion of patients over 60 years old,ECOG PS scores of 2-3,B-symptoms,Ann Arbor gradesⅢ-Ⅳ,abnormal LDH and high,medium-high risk IPI were higher than the high CXI group,with statistically significant differences(P<0.05).The CR of all patients in the low CXI group was lower than that in the high CXI group,and the number of cases with disease progression was higher than that in the high CXI group(P<0.05).The PFS and OS of patients with high CXI were higher than those with low CXI(P<0.05).Multivariate analysis showed that BMI<18.5,high-intermediate risk and high risk IPI,and low CXI were independent prognostic indicators for PFS and OS(P<0.05).The incidence of grade 3-4 anemia,thrombocytopenia and febrile neutropenia in the high CXI group were lower than those in the low CXI group,and the non-hematologic toxicity of grade 3 or above was lower than that in the low CXI group(P<0.05).The number of cases with early treatment discontinuation in the low CXI group was higher than that in the high CXI group(P<0.05).Conclusion CXI is an effective biomarker of cancer cachexia,which can predict the survival rate,treatment response and treatment-related toxicity of DLBCL patients.
作者
杨宇娟
王倩
向立丽
蒙延娜
张慈现
付杰
YANG Yujuan;WANG Qian;XIANG Lili;MENG Yanna;ZHANG Cixian;FU Jie(Department of Hematology,Xuzhou Central Hospital,Xuzhou,221009,China)
出处
《临床血液学杂志》
2023年第11期808-812,共5页
Journal of Clinical Hematology
