【摘要】 目的：观察含BTK抑制剂的化疗方案治疗复发难治套细胞淋巴瘤（MCL）的疗效及预后。方法：回顾性分析134例复发难治MCL患者的临床资料，观察患者临床特征，以及化疗方案对疗效、总生存（OS）率及无进展生存（PFS）率的影响。结果：患者中位年龄58(56-61)岁，男女比例约为2.9∶1,Ann Arbor分期Ⅲ-Ⅳ期患者占77.6%，结外受累部位>2占43.3%，骨髓受累占60.4%，胃肠道受累占24.6%，肝脾肿大占38.1%。中位随访时间30(2-103)个月，总有效率41.8%,3年PFS未达到，3、5年OS率分别为62.7%、53.8%。含BTK抑制剂方案治疗组总有效率56.9%，优于不含BTK抑制剂方案治疗组的32.5%，比较差异有统计学意义（P=0.006），两组PFS率差异亦有统计学意义（P=0.002），而OS率差异无统计学意义（P>0.05）。经典型与特殊型之间PFS率差异无统计学意义（P>0.05），而OS率差异有统计学意义（P<0.001）。Ki-67是复发难治MCL患者OS和PFS的影响因素。Ki-67、B症状、套细胞淋巴瘤国际预后指数评分、Ann Arbor分期是影响患者OS的独立预后因素。二线治疗方案是影响患者PFS的独立预后因素。结论：含BTK抑制剂方案治疗复发难治MCL有效率高，且可明显延长PFS,Ki-67、B症状、套细胞淋巴瘤国际预后指数评分、Ann Arbor分期为复发难治MCL的独立预后因素。更多还原

【Abstract】 Objective: To investigate the efficacy and prognosis of chemotherapy regimen containing Bruton′s tyrosine kinase(BTK) inhibitor in the treatment of relapsed/refractory mantle cell lymphoma(R/R MCL). Methods: The clinical data of 134 patients with R/R MCL were collected and analyzed retrospectively. The clinical characteristics of patients and effect of chemotherapy regimen on efficacy, overall survival(OS) and progression-free survival(PFS) were observed. Results: The median age of the patients was 58(56-61) years old, and male to female ratio was about 2.9∶1. Patients with Ann Arbor stage III-IV accounted for 77.6%, extranodal involvement > 2 for 43.3%, bone marrow involvement for 60.4%, gastrointestinal involvement for 24.6%, and hepatosplenomegaly for 38.1%. The median follow-up time was 30(2-103) months, overall response rate(ORR) was 41.8%, 3-year PFS was not reached, and 3-year and 5-year OS rate was 62.7% and 53.8%, respectively. The ORR of BTK inhibitor group was 56.9%, which was higher than 32.5% of non-BTK inhibitor group(P=0.006). The difference was statistically significant in PFS between the two groups(P=0.002), but was not in OS(P>0.05). The difference was statistically significant in OS between classical and special morphology(P<0.001), but was not in PFS(P>0.05). Ki-67 was an influencing factor for OS and PFS. Multivariate analysis showed that Ki-67, B symptoms, MIPI score, and Ann Arbor stage were independent prognostic factors affecting patients′ OS. The secondline treatment regimen was an independent prognostic factor affecting patients′ PFS. Conclusions: The chemotherapy regimen containing BTK inhibitors can effectively improve the efficacy and prolong the PFS of R/R MCL patients. Ki-67, B symptoms, MIPI score, and Ann Arbor stage are independent prognostic factors for R/R MCL patients.更多还原