Objective: To investigate the clinical characteristics, prognostic factors, and treatment outcomes of patients with limited-stage (Ann Arbor stage I or II) mantle cell lymphoma (MCL).
Methods: Examining consecutive the clinical characteristics, treatment outcomes and prognostic factors of 47 patients with stage I or II MCL diagnosed in Affiliated Tumor Hospital of Guangxi Medical University from January 2005 to June 2020 were analyzed retrospectively.
Results: The median age of patients was 62(37-78) years old. 36 patients were male, accounting for 76.6% of the whole. Among these, 74.5% (n=35) of the diagnoses were estimated at II stage. According to Mantle cell lymphoma International Prognostic Index (MIPI), 28 patients (59.6%) were classified as low risk. Patients who received first-line treatment and could be evaluated received rituximab combined chemotherapy, chemotherapy alone, cytarabine containing chemotherapy or chemotherapy combined with local radiotherapy, the different first-line therapies did not affect the complete response (CR) rate of patients (P>0.05). The median follow-up time was 81.5 months, the 5-year progression-free survival (PFS) was 37.4% and the 5-year overall survival (OS) rate was 80.6%. Multivariate analysis showed that Ki-67>30% (P<0.05) the independent adverse prognostic factor for PFS and OS.
Conclusion: Limited-stage MCL is rare. Patients with limited-stage MCL had a better outcome than those with III-IV stage MCL. Patients with limited-stage MCL whose Ki-67≤30% had better PFS and OS.
题目: 局限期套细胞淋巴瘤的临床特征和预后相关因素分析.
目的: 探讨局限期(Ann Arbor I期或II期)套细胞淋巴瘤(MCL)患者的临床特征、预后相关因素和治疗结果.
方法: 回顾性收集2005年1月至2020年6月在广西医科大学附属肿瘤医院确诊的47例初治I期和II期MCL患者的临床病理资料,分析患者的治疗结果以及预后影响因素.
结果: 患者中位年龄为62 (37-78) 岁;男性占76.6%(36例)。35例(74.5%)患者诊断时为II期,28例(59.6%)患者为MIPI评分低危组。接受治疗并可评价的患者一线治疗接受了利妥昔单抗联合化疗、单纯化疗、含阿糖胞苷方案化疗或化疗联合局部放疗,各方案组患者完全缓解(CR)率的差异无统计学意义(P>0.05)。中位随访时间81.5个月,5年无进展生存(PFS)和总生存(OS)率分别为374%和80.6%。多因素分析结果发现,Ki-67>30%是影响患者PFS和OS的独立不良预后因素(P<0.05).
结论: 局限期的MCL极少见,预后较III-IV期MCL好。本研究中Ki-67≤30%的局限期MCL患者具有较好的PFS和OS.
Keywords: clinical feature;; limited-stage; mantle cell lymphoma; prognosis; treatment.