本帖最后由 橙色雨丝 于 2015-6-30 14:18 编辑
Outcomes of transformed follicular lymphoma in the modern era: a report from the National LymphoCare Study (NLCS) 当今时代转化后滤泡性淋巴瘤的转归：来自NLCS的研究报告 Key Points要点
The median post-transformation survival of 5 years suggests improved outcomes for transformed follicular lymphoma in the modern era. 转化后中位5年的生存期表明在当今时代转化后的滤泡性淋巴瘤转归的改善
Transformation at the time of diagnosis portends a more favorable prognosis with 5-year PFS and OS rates of 66% and 88%, respectively. 在确诊时的转化预示相对较好的预后，5年无进展生存率和总生存率分别达到66%和88%。
Abstract摘要
We assessed the incidence, prognostic features, and outcomes associated with transformation of follicular lymphoma (FL) among 2652 evaluable patients prospectively enrolled in the National LymphoCare Study. At a median follow-up of 6.8 years, 379/2652 (14.3%) patients transformed following the initial FL diagnosis, including 147 pathologically confirmed and 232 clinically suspected cases. ECOG performance status > 1, extranodal sites > 1, elevated LDH, and B symptoms at diagnosis were associated with transformation risk. 我们分析了前瞻性的入组NLCS研究的可评估的2652例滤泡性淋巴瘤患者当中出现大细胞转化的几率，预后特点，和转归情况。在6.8年中位随访期后，379/2652（14.3%）例患者在初诊为滤泡性淋巴瘤后出现了转化，其中有147例经病理学确认，232例是临床可疑病例。在确诊时ECOG行为状态>1，结外侵犯部位>1，LDH升高，和B症状与转化的风险相关。
Relative to observation, patients initiating treatment at diagnosis had a reduced risk of transformation, hazard ratio (HR) .58 (95% CI 0.46 – 0.75). The risk of transformation was similar in patients treated with R-CHOP compared to R-CVP (adjusted HR 0.94 [95% CI 0.62 – 1.42]). Maintenance rituximab was associated with reduced transformation risk (HR 0.67; 95% CI 0.46 – 0.97). 5-year survival from diagnosis was significantly worse for patients with versus without transformation (75%, 95% CI 70-79, versus 85%, 95% CI 83-86). The median overall survival post transformation was 5 years. 47 patients with evidence of transformation at the time of diagnosis shared similar prognostic factors and survival rates to those without transformation. Improved outcomes for transformation in the modern era are suggested by this observational study. Trial registered NCT00097565at https://clinicaltrials.gov.相对于观察组，在确诊时就开始治疗的患者有较低的转化风险，风险比0.58。用R-CHOP治疗和用R-CVP治疗的患者的转化风险相似，风险比0.94。美罗华维持与较低的转化风险相关，风险比0.67。确诊时存在转化的患者的5年生存率比没有转化的患者明显较差（75%对85%）。发生转化后的中位生存期为5年。47例在确诊时有转化证据的患者与没有转化的患者有相似的预后因素和生存率。这项观察性的研究提示在当今时代发生转化的滤泡性淋巴瘤患者的转归有所改善。 Submitted January 8, 2015. Accepted June 7, 2015. Copyright © 2015 American Society of Hematology
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