增强剂量免疫化疗联合一线自体外周血造血干细胞移植治疗年轻、高危侵袭性B细胞淋巴瘤疗效及预后因素分析

OBJECTIVE: This study aimed to determine the efficacy of dose-enhanced immunochemotherapy followed by autologous peripheral blood stem cell transplantation（ASCT）in young patients with newly diagnosed high-risk aggressive B-cell lymphoma. METHODS: A retrospective study was conducted to examine the clinical and survival data of young patients with high-risk aggressive B-cell lymphoma who received dose-enhanced immunochemotherapy and ASCT as first-line treatment between January 2011 and December 2018 in Blood Diseases Hospital. RESULTS: A total of 63 patients were included in the study. The median age range was 40（14–63）years old. In terms of the induction therapy regimen, 52 cases received R-DA-EP（D）OCH, and the remaining 11 received R-HyperCVAD/R-MA. Sixteen（25.4％）patients achieved partial response in the mid-term efficacy assessment, and ten of them were evaluated as complete response after transplantation. The median follow-up was 50（8–112）months, and the 3-year progression-free survival（PFS）rate and overall survival（OS）rate were（83.9±4.7）％ and（90.4±3.7）％, respectively. Univariate analysis demonstrated that age-adjusted international prognostic index ≥2 scores was a negative prognostic factor for OS（P＝0.039）, and bone marrow involvement（BMI）was an adverse prognostic factor for OS（P<0.001）and PFS（P＝0.001）. However, multivariate analysis confirmed that BMI was the only independent negative predictor of OS（P＝0.016）and PFS（P＝0.001）. CONCLUSION: The use of dose-enhanced immunochemotherapy in combination with ASCT as first-line therapy in the treatment of young, high-risk aggressive B-cell lymphoma results in good long-term outcomes, and BMI remains an adverse prognostic factor.