利妥昔单抗时代转化型滤泡性淋巴瘤的治疗模式、结局与预后因素

Haematologica · 2026年9月24日 · Day 等 20 位作者

一分钟了解要点344例真实世界队列：转化后中位无事件生存仅9个月，中位总生存4.9年。结果转化时中位年龄64岁，初始治疗以R-CHOP类方案（45%）和强化/挽救方案（25%）为主；转化后中位无事件生存期（EFS，未发生疾病事件的时间）仅9个月，2年EFS为30%；中位总生存4.9年，2年、5年总生存率分别为66%和49%。

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Histologic transformation (HT) is the leading of death in follicular lymphoma (FL), yet outcomes remain poorly defined due to small cohorts and heterogenous definitions. To characterize outcomes and treatment patterns in the rituximab era we analyzed 344 patients with an initial biopsy-confirmed FL diagnosis between 2002 and 2022 who subsequently developed biopsy-confirmed HT in the Lymphoma Epidemiology of Outcomes (LEO) Consortium of Real-World Evidence (CReWE). Median age at HT was 64 (IQR 57-72). Initial treatment for HT (index therapy) included R-CHOP-like (n=154, 45%) and aggressive/salvage (n=85, 25%). The median event free survival (EFS) from HT was 9 months (95% CI, 7-11), and 2-year EFS was 30% (95% CI, 26%-36%). Median OS from HT was 4.9 years (95% CI, 4.0-7.5) with 2-year and 5-year OS estimates of 66% (95% CI, 61%-71%) and 49% (95% CI, 43%-56%), respectively. Relapses after HT occurred in 60%. Relapse histology included DLBCL 70%, FL 15%, and HGBCL 12%. Treatment following relapse from index therapy was commonly aggressive/salvage (often incorporating ASCT/CAR-T) in 44%. FLIPI (3-5), FL3A histology, IPI (4-5), ECOG >1, diagnosis to HT.

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