[Dose-enhanced immunochemotherapy followed by first-line autologous peripheral blood stem cell transplantation for young patients with high-risk aggressive B-cell lymphoma: an efficacy and prognostic factor analysis].

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) . Conclusions: 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.目的： 探讨增强剂量免疫化疗联合自体外周血造血干细胞移植（ASCT）治疗初治、年轻、高危侵袭性B细胞淋巴瘤患者的疗效及预后因素。 方法： 回顾性分析2011年1月至2018年12月在中国医学科学院血液病医院应用增强剂量免疫化疗联合ASCT治疗的63例初治、年轻、高危侵袭性B细胞淋巴瘤患者的临床和生存资料。 结果： 63例患者的中位年龄为40（14~63）岁。诱导治疗方案包括R-DA-EP(D)OCH（52例）和R-HyperCVAD/R-MA（11例）。16例（25.4%）患者中期疗效评估为部分缓解，其中10例移植后获得完全缓解。中位随访50（8~112）个月，3年无进展生存（PFS）率和总生存（OS）率分别为（83.9±4.7）%和（90.4±3.7）%。单因素分析显示年龄调整的国际预后指数评分≥2分是影响OS的预后不良因素（P＝0.039），骨髓受累（BMI）是影响OS（P<0.001）和PFS（P＝0.001）的预后不良因素。多因素分析显示BMI是OS（P＝0.016）和PFS（P＝0.001）的唯一独立预后不良因素。 结论： 一线应用增强剂量免疫化疗联合ASCT治疗年轻、高危侵袭性B细胞淋巴瘤可获得良好的长期疗效，BMI为不良预后因素。.