微信公众号

官网二维码
中国癌症防治杂志

中国癌症防治杂志 ›› 2021, Vol. 13 ›› Issue (4): 359-364.doi: 10.3969/j.issn.1674-5671.2021.04.05

• 恶性血液病综合治疗专栏 • 上一篇    下一篇

PD⁃1抑制剂在弥漫大B细胞淋巴瘤维持治疗中的作用：单中心回顾性病例对照研究

    

  1. 武汉科技大学医学院；国家癌症中心 国家肿瘤临床医学研究中心 中国医学科学院肿瘤医院深圳医院血液肿瘤科
  • 出版日期:2021-08-25 发布日期:2021-09-17
  • 通讯作者: 郭智 E-mail：guozhi77@126.com
  • 基金资助:
    白求恩·拓益中青年医师科研能力培养项目（BQE-TY-SSPCCD-S-08）；吴阶平医学基金会临床科研专项（32067502020-10-17）

Efficacy of PD⁃1 inhibitors in the maintenance treatment for diffuse large B⁃cell lymphoma: A single⁃center retrospective case⁃control study

  1.  
  • Online:2021-08-25 Published:2021-09-17

PDF (PC)

267

赞

摘要： 目的 探讨PD-1抑制剂维持治疗对弥漫大B细胞淋巴瘤（diffuse large B-cell lymphoma，DLBCL）患者预后的影响。方法 回顾性分析本中心2018年3月至 2019年3月收治的经过诱导化疗获得完全缓解（CR）的DLBCL患者，治疗组接受PD-1抑制剂维持治疗（n=30），以同期未进行维持治疗的30例患者为对照组，比较两组患者的无复发生存期（relapse-free survival，RFS），并观察PD-1抑制剂维持治疗的疗效及安全性。结果 随访截至2021年3月，治疗组和对照组的2年RFS率分别为80.0%和73.3%（P=0.542）。亚组分析显示，在IPI评分≥3分（70.0% vs 22.2%，P=0.037）、non-GCB型（90.9% vs 45.5%，P=0.022）患者中，经PD-1抑制剂维持治疗后2年RFS率均较对照组获益明显。治疗组主要不良反应均为Ⅰ~Ⅱ级：皮疹2例、白细胞下降5例、甲状腺功能减退3例、肝功能损害1例、血小板减低1例、糖脂代谢异常1例、消化道反应1例。结论 应用PD-1抑制剂维持治疗未能明显改善DLBCL患者的RFS，但在IPI评分≥3分、non-GCB型DLBCL患者中具有潜在优势。

关键词: PD-1抑制剂, 弥漫大B细胞淋巴瘤, 维持治疗, 无复发生存率, 预后因素

Abstract: Objective To investigate the impact of PD-1 inhibitors maintenance therapy on prognosis of diffuse large B-cell lymphoma(DLBCL) patients. Methods The DLBCL patients who achieved complete response(CR) after induction chemotherapy admitted to our center from March 2018 to March 2019 were retrospectively analyzed. Among them, the therapy group received PD-1 inhibitors maintenance therapy(30 cases), and 30 patients who did not receive maintenance therapy during the same period were selected as the control group. The relapse-free survival(RFS) rate of the two groups were compared, and the efficacy and safety of PD-1 inhibitors maintenance therapy were observed. Results Follow-up until March 2021, the 2-year RFS rates of the therapy group and the control group were 80.0% and 73.3%(P=0.542), respectively. Subgroup analysis showed that the patients with international prognostic index(IPI) score ≥ 3points (70% vs 22.2%, P=0.037), non-GCB type(90.9% vs 45.5%, P=0.022) received PD-1 inhibitors maintenance treatment had a significant benefit in 2-year RFS rates compared with the control group. The main adverse reactions in the therapy group were controllable, all of grade Ⅰ-Ⅱ, including rash(2 cases), leukopenia(5 cases), hypothyroidism(3 cases) , liver damage(1 cases), thrombocytopenia(1 cases), abnormal glucose and lipid metabolism(1 cases) , digestive tract reaction(1 cases). Conclusions The maintenance treatment with PD-1 inhibitors cannot significantly improve the RFS of patients with DLBCL, but it has a potential advantages in patients with IPI score ≥ 3points and non-GCB DLBCL.

Key words: PD-1 inhibitors, Diffuse large B-cell lymphoma, Maintenance therapy, Relapse-free survival, Prognostic factors

中图分类号: 

  • R733