期刊
BLOOD
卷 124, 期 15, 页码 2354-2361出版社
AMER SOC HEMATOLOGY
DOI: 10.1182/blood-2014-05-578963
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类别
资金
- Millennium
- Seattle Genetics
- Celgene
- Spectrum Pharmaceuticals
- Janssen
- GlaxoSmithKline
- Otsuka
- Genentech
- Acerta
- Infinity
- Onyx
- Janssen Oncology
- Gilead Sciences
- Spectrum
- Bristol Meyers Squibb
- Roche
Patients with double-hit lymphoma (DHL), which is characterized by rearrangements of MYC and either BCL2 or BCL6, face poor prognoses. We conducted a retrospective multicenter study of the impact of baseline clinical factors, induction therapy, and stem cell transplant (SCT) on the outcomes of 311 patients with previously untreated DHL. At median follow-up of 23 months, the median progression-free survival (PFS) and overall survival (OS) rates among all patients were 10.9 and 21.9 months, respectively. Forty percent of patients remain disease-free and 49% remain alive at 2 years. Intensive induction was associated with improved PFS, but not OS, and SCT was not associated with improved OS among patients achieving first complete remission (P = .14). By multivariate analysis, advanced stage, central nervous system involvement, leukocytosis, and LDH>3 times the upper limit of normal were associated with higher risk of death. Correcting for these, intensive induction was associated with improved OS. We developed a novel risk score for DHL, which divides patients into high-, intermediate-, and low-risk groups. In conclusion, a subset of DHL patients may be cured, and some patients may benefit from intensive induction. Further investigations into the roles of SCT and novel agents are needed.
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