摘要
目的了解我国淋巴母细胞淋巴瘤(LBL)患者的临床特点及不同治疗方案的近、远期疗效。方法对43例LBL患者进行回顾性分析:结果①LBL患者中多数发病年龄较轻(中位年龄21岁),以男性为主,其中T—LBL患者的纵隔巨大肿块的发生率为63.0%;②37例可评价疗效的患者治疗总有效率为81.1%,其中完全缓解(CR)率为67.6%。急性淋巴细胞白血病(ALL)样治疗方案组和非霍奇金淋巴瘤(NHL)样治疗方案组的治疗有效率分圳为94.4%和68.4%,CR率分别为83.3%和52.6%;③11例患者进行造血干细胞移植(HSCT),其总生存(OS)和无进展生存(PFS)时间明显长于ALL样治疗方案组(P值分别为0.018和0.025)和NHL样治疗方案组(P值分别为0.016和0.011)。NHL样治疗方案组、ALL样治疗方案组、HSCT组的预期3年OS率分别为(14.4±9.4)%、(20.2±12.7)%和(79.5±13.1)%。结论①LBL常发生于年轻患者,男性多于女性,初诊时外周血较少受累;与B-LBL相比,T—LBL常有纵隔肿块发生及胸腔积液、心包积液等浆膜腔积液。②对于高度侵袭性的LBL.应当给予强烈的ALL样治疗方案治疗,在CR1期行HSCT可明显提高生存率。
Objective To investigate the clinical features and treatment outcomes of different regimens in Chinese patients with lymphohlastic lymphoma(LBL). Methods Forty-three patients with LBL were retrospectively analysed, of which 30 were T-LBL, and 13 B-LBL. Results (1) Most patients were young men with a median age of 21, and 63.0% of the T-LBL patients had mediastinal masses. (2) Treatment outcome could be assessed in 37 cases, of which the response rate (RR) was 81. 1% and complete remission (CR) rate was 67.6%. The RR and CR rates in patients treated with regimens for ALL (ALL-like group) and those treated with regimens for NHL( NHL-like group) were 94.4% , 68.4% and 83.3% , 52.6% , respectively. (3) The estimated median overal survival(OS) and progression free survival (PFS) of hematopoietie stem cell transplantation (HSCT) group were significant longer than those of ALL-like group(P = 0.018, P =0.025)and NHL-like group(P = 0. 016,P = 0.011 ). The OS at 5 years in NHL-like group, ALL-like group and HSCT group were ( 14.4 ± 9.4 ) % , ( 20.2 ± 12.7 ) % and (79.5 ±13.1 ) % , respectively. Conclusion (1)LBL is more common in young men, with less involvement of peripheral blood. Compared with B- LBL,T-LBL often has a mediastinal mass and serious cavity effusion. (2) Intensive treatment regimens for ALL should be used in LBL. HSCT at CRI can improve outcome obviously.
出处
《中华血液学杂志》
CAS
CSCD
北大核心
2009年第7期446-449,共4页
Chinese Journal of Hematology
基金
基金项目:“十一五”国家科技支撑重点项目(2008BAI61B01)
卫生部临床学科重点项目(2007-2009)
关键词
淋巴瘤
淋巴母细胞
疾病特征
治疗结果
Lymphoma, lymphoblastic
Disease attributes
Treatment outcome