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岳文勤,徐丽丽,杨建民,陈洁*.2种滤泡性淋巴瘤国际预后指数对滤泡性淋巴瘤的预后意义[J].Academic Journal of Second Military Medical University ,2021,42(9):967-974
2种滤泡性淋巴瘤国际预后指数对滤泡性淋巴瘤的预后意义    点此下载全文 Fulltext
岳文勤  徐丽丽  杨建民  陈洁*
长海医院血液科, 上海 200433
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      目的 比较滤泡性淋巴瘤国际预后指数(FLIPI)和FLIPI2在滤泡性淋巴瘤(FL)预后评估中的意义。方法 收集2007年11月16日至2019年6月1日海军军医大学(第二军医大学)长海医院血液科收治的107例初诊FL患者的临床资料,其中52例患者接受含利妥昔单抗的化疗方案(利妥昔单抗联合化疗组),55例接受传统化疗方案(单纯化疗组)。按FLIPI和FLIPI2评分对所有患者进行危险分层,分析患者的无进展生存(PFS)率。结果 107例FL患者的中位年龄为53(25~77)岁,3年和5年PFS率分别为83.8%和74.9%。FLIPI评分低危(评分0~1分)、中危(评分2分)、高危(评分≥3分)组患者的5年PFS率分别为91.7%、72.0%和50.4%(χ2=14.274,P<0.001); FLIPI2评分低危(评分0~1分)、中危(评分2分)、高危(评分≥3分)组患者的5年PFS率分别为86.8%、64.4%和39.0%(χ2=16.675,P<0.001),差异均有统计学意义。在利妥昔单抗联合化疗组,根据FLIPI2预后评分模型分组,5年PFS率差异有统计学意义(χ2=21.597,P<0.01);在单纯化疗组,根据FLIPI预后评分模型分组,5年PFS率差异有统计学意义(χ2=11.982,P=0.003)。在年龄≤60岁组,根据FLIPI和FLIPI2评分分组,低、中和高危组患者的5年PFS率差异均有统计学意义(P均<0.01),而在利妥昔单抗联合化疗且年龄≤60岁组,仅FLIPI2可对FL患者进行良好的危险分层,低、中和高危组患者的5年PFS率分别为95.2%、87.5%和50.0%(χ2=13.989,P<0.001)。结论 利妥昔单抗时代,FLIPI2相比FLIPI可对FL患者进行更好的危险分层,年龄不再是影响FL患者PFS的因素。
关键词:滤泡性淋巴瘤  滤泡性淋巴瘤国际预后指数  预后  存活率分析  利妥昔单抗
Prognostic significance of 2 follicular lymphoma international prognostic indexes for follicular lymphoma    Fulltext
YUE Wen-qin  XU Li-li  YANG Jian-min  CHEN Jie*
Department of Hematology, Changhai Hospital, Naval Medical University (Second Military Medical University)
, Shanghai 200433, China
*Corresponding author
Fund Project:Supported by General Program of National Natural Science Foundation of China (81970178).
      Objective To compare the prognostic significance of follicular lymphoma international prognostic index (FLIPI) and FLIPI2 for follicular lymphoma (FL). Methods The clinical data of 107 newly diagnosed FL patients who were admitted to the Department of Hematology, Changhai Hospital, Naval Medical University (Second Military Medical University) from Nov. 16, 2007 to Jun. 1, 2019 were collected, of which 52 patients received rituximab combined chemotherapy and 55 patients received chemotherapy alone. All patients were stratified according to FLIPI and FLIPI2 scores, and the progress-free survival (PFS) rate was analyzed. Results The median age of the 107 FL patients was 53 (25-77) years. The 3- and 5-year PFS rates of the 107 patients were 83.8% and 74.9%, respectively. According to FLIPI scores, the 5-year PFS rates of low-risk (score 0-1), intermediate-risk (score 2), and high-risk (score ≥ 3) groups were 91.7%, 72.0%, and 50.4%, respectively (χ2=14.274, P<0.001); according to FLIPI2 scores, the 5-year PFS rates of low-risk (score 0-1), intermediate-risk (score 2), and high-risk (score ≥ 3) groups were 86.8%, 64.4%, and 39.0%, respectively (χ2=16.675, P<0.001). In the rituximab combined chemotherapy group, there was significant difference in the 5-year PFS rate according to the FLIPI2 prognostic scoring model (χ2=21.597, P<0.01). In the chemotherapy alone group, according to the FLIPI prognostic scoring model, the difference in 5-year PFS rate was significant (χ2=11.982, P=0.003). The 5-year PFS rates of low-, intermediate- and high-risk groups had significant differences for patients aged ≤ 60 years according to FLIPI and FLIPI2 scores (all P<0.01). In the group with rituximab combined chemotherapy and age ≤ 60 years, FLIPI2 performed well in risk stratification for FL patients, and the 5-year PFS rates of patients in the low-, intermediate- and high-risk groups were 95.2%, 87.5% and 50.0%, respectively (χ2=13.989, P<0.001). Conclusion FLIPI2 performs better in risk stratification for FL patients than FLIPI in the era of rituximab. Age is no longer a prognostic factor affecting PFS in FL patients.
Keywords:follicular lymphoma  follicular lymphoma international prognostic index  prognosis  survival analysis  rituximab
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