原发性中枢神经系统淋巴瘤患者的潜在预后参数和真实世界数据:旧的基础上的一块新砖

Tuba Ersal, V. Ozkocaman, Ibrahim Ethem Pınar, Cumali Yalçın, B. Orhan, Ömer Candar, Sinem Çubukçu, Tuba Güllü Koca, R. Ali, F. Özkalemkaş
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摘要

目的:我们旨在评估原发性中枢神经系统淋巴瘤(PCNSL)患者的潜在预后因素。方法:对32例PCNSL患者进行回顾性分析。结果:所有患者均以高剂量甲氨蝶呤为主的化疗为一线治疗。总生存期30.0±7.2个月。部分反应和无反应的患者死亡率更高。白细胞和中性粒细胞水平升高与高死亡率有关。此外,SIIL是全身性免疫炎症(SII)和乳酸脱氢酶(LDH)的产物;SIRIL是全身免疫反应指数(SIRI)和LDH的产物;NLL作为中性粒细胞-淋巴细胞比率和LDH的产物,首次被考虑到本研究的目的。NLL、SIIL和SIIL指数升高与死亡率相关。基于包括与死亡率相关的危险因素在内的多变量回归模型,SIIL水平升高、放疗、部分缓解和无缓解是死亡率的独立预测因素。结论:SIIL、SIIL和NLL是PCNSL的预后因素。确定预后因素和风险概况可以预测对更强化治疗的需求,特别是在高风险的年轻患者中。
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Potential prognostic parameters and real-world data in patients with primary central nervous system lymphoma: a new brick on the old ones
Objectives: We aimed to evaluate the potential prognostic factors of patients with primary central nervous system lymphoma (PCNSL). Methods: Thirty-two patients with PCNSL were retrospectively analyzed. Results: All the patients received high doses of methotrexate-based chemotherapy as the first-line treatment. Overall survival was 30.0 ± 7.2 months. Those with partial response and without response had a higher risk of mortality. The increased leukocyte and neutrophil levels were associated with high mortality. Besides, the SIIL as a product of the systemic immune inflammation (SII) and lactate dehydrogenase (LDH); the SIRIL as a product of systemic immune response index (SIRI) and LDH; and the NLL as a product of neutrophil-lymphocyte ratio and LDH were taken into consideration for the first time for the purposes of the present study. Elevated NLL, SIIL, and SIRIL indexes were associated with mortality. Elevated SIIL level, radiotherapy, and partial and no response were the independent predictors of mortality on the basis of the multivariable regression model including the risk factors associated with mortality. Conclusions: SIIL, SIRIL and NLL are prognostic factors in PCNSL. Determining the prognostic factors and risk profile may predict the requirement for more intensive treatment, especially in young patients at high risk.
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