岁月不拘，时节如流。不觉间2023年已离我们远去。回首过去的一年，血液领域蓬勃发展，众多创新性研究成果登上国际舞台，给患者带来更多希望，给医生带来更大信心。
本期《肿瘤瞭望-血液时讯》特别邀请到芬兰赫尔辛基大学医院综合癌症中心Sirpa Leppä教授，就弥漫大B细胞淋巴瘤（DLBCL）的相关研究进行解读分享，以期鉴往知来，更好开启2024！
《肿瘤瞭望-血液时讯》：您的团队在2023 EHA大会上，口头报告了一项研究，比较了R-miniCHOP方案和R-pola-miniCHP方案在老年虚弱DLBCL患者中的安全性。请您介绍并解读一下该研究？
Sirpa Leppä教授：这项研究旨在探讨Polatuzumab vedotin与MiniCHP联合使用是否能够改善老年患者的治疗结局。之所以开展这项研究，是因为在过去20年，所有侵袭性淋巴瘤患者的生存期都得到了改善，而唯独老年患者的生存期没有改善，很显然对于这类老年患者而言存在未满足的医疗需求。这是一项初始的安全性分析，因此我们还没有任何疗效数据，但我们现在知道这种方案是可行的。我们确实在R-pola-miniCHP组中观察到了更多的胃肠道毒性反应，但这些毒性反应是可耐受且暂时的，未对继续治疗造成影响。
图 1. 两组患者治疗不良事件
Oncology Frontier-Hematology Frontier: Our first question is about an oral study reported by your team S227 compared the safety of R-miniCHOP regimen with R-pola-miniCHP regimen in elderly and frail DLBCL patients. Please introduce and interpret this study.
Professor Sirpa Leppä：The study is asking the question whether combination or adding polatuzumab vedotin to miniCHP would improve the outcome of the elderly patients. And the rationale for this study is that the over survival of all aggressive lymphoma patients has improved within the last two decades in all age groups except the elderly population. This is the only one that there is no improvement and there is clearly unmet medical need for this elderly patient population. This is an initial safety analysis, so we don't have any efficacy data yet, but we now know that the regimen is feasible.We did see some more gastrointestinal toxicity in the R-pola-miniCHP arm. But it was tolerable. It was transient. And it did not interfere the continuation of the treatment.
《肿瘤瞭望-血液时讯》：请您谈谈过去一年在DLBCL方面有哪些值得关注的研究进展？
Sirpa Leppä教授：在2023 EHA的全体大会上，有一项关于纵隔B细胞淋巴瘤的研究报告，提到在化疗后PET阴性则可以省略放疗，我认为这是一项改变实践的研究。因此，在免疫化疗后PET结果为阴性的患者中，无需进行放疗。
Oncology Frontier-Hematology Frontier: Could you please talk about any noteworthy research progress in DLBCL over the past year?
Professor Sirpa Leppä：In the plenary session of 2023 EHA, there was a talk about mediastinal B cell lymphoma, omitting radiotherapy if the PET was negative after chemotherapy, and I think is a practice changing study. So there is no need to give radiotherapy for the patients who are PET negative after immuno-chemotherapy.
专家简介
Sirpa Leppä教授
芬兰赫尔辛基大学和赫尔辛基大学医院综合癌症中心