不同年龄组低级别滤泡淋巴瘤的临床特征及预后分析

目的:分析低级别滤泡淋巴瘤(follicular lymphoma,FL)在各年龄段人群中的临床特征及预后。方法:收集2011年1月至2019年12月郑州大学第一附属医院初治的82例低级别FL患者的病例资料,男女比为1∶1.05,中位年龄52(19～84)岁。分类变量行Chi-square检验,采用Kaplan-Meier法、Logistic单因素分析及Cox回归模型多因素分析进行生存资料分析。结果:82例患者分为年龄<40岁、40～59岁和≥60岁3个组。随着年龄段的上升,患者多见红细胞沉降率(erythrocyte sedimentation rate,ESR)增快、外周血血小板与淋巴细胞比值(platelet to lymphocyte ratio,PLR)升高、Bcl-2表达呈阳性的患者比例升高、ECOG评分和FLIPI-2评分升高,且初治效果达到完全缓解(complete response,CR)的比例降低(P<0.05)。随访的73例患者2、5年总生存率(overall survival,OS)分别为97.2%和74.1%,无进展生存率(progression-...

Clinical characteristics and prognosis of low- grade follicular lymphoma in different age groups

  Objective  To analyze and compare the clinical characteristics and prognosis of low-grade follicular lymphoma (FL) in different age groups.  Methods  We obtained the data of clinical and pathological indicators from 82 patients with low-grade FL who were newly treated at The First Affiliated Hospital of Zhengzhou University from January 2011 to December 2019. The male to female ratio was 1:1.05, with a median age of 52 (19-84) years. Categorical variables were analyzed using the Chi-square test. The Kaplan-Meier method was used for survival analysis, and differences in survival were assessed using the Log-rank test. Logistic univariate analysis and Cox multivariate regression model analysis were performed to analyze the factors affecting survival.  Results  The 2-year and 5-year overall survival (OS) and progression-free survival (PFS) rates in the 73 patients who completed follow-up were 97.2% and 74.1% and 91.5% and 88.8%, respectively. Eighty-two patients were assigned into three age groups: < 40 years, 40-59 years, and ≥ 60 years. With increasing age, patients showed a higher erythrocyte sedimentation rate (ESR), platelet to lymphocyte ratio (PLR), Eastern Cooperative Oncology Group (ECOG) score, follicular lymphoma international prognostic index-2 (FLPI-2) score, and Bcl-2 positive ratio. Moreover, the complete response rate reduced after initial treatment (P < 0.05). The 5-year OS rates in the < 40 years, 40-59 years, and ≥ 60 years age groups were 100%, 73.8%, and 46.5%, respectively (P=0.014). There was no significant difference in PFS between the groups (P=0.190). Concerning the chemotherapy regimen, the 5-year OS rates in the rituximab plus chemotherapy and chemotherapy only groups were 85.7% and 69.3%, respectively (P=0.004); the corresponding 5-year PFS rates were 96.8% and 56.3%, respectively (P < 0.001). In the chemotherapy only group, the OS rates of patients aged < 40, 40-59, and ≥ 60 years were 100.0%, 75.0%, and 71.4%, respectively (P=0.048). There was no significant difference in OS in each age group (P=0.050). With respect to the Ann Arbor stage, the OS rates of patients aged < 40, 40-59, and ≥ 60 years were 100%, 88.90%, and 47.7%, respectively, in the advantage groups (P=0.046); however, there was no significant difference in the 5-year OS of the early group (stage Ⅰ + Ⅱ) at different age stratification (P=0.414). On univariate analysis, male sex was an adverse prognostic factor, and on multivariate analysis, male sex was correlated with a poorer PFS.  Conclusions  The prognosis of patients with low-grade FL worsens with increasing age. Male sex is a poor prognostic factor. Administration of rituximab plus chemotherapy can improve the prognosis and prolong survival.