B细胞淋巴瘤老年患者的临床特征、生存和预后因素分析  

Analysis of the clinical features,survival and prognosis-related factors for elderly patients with B-cell non-Hodgkin lymphoma

作　　者：唐曦[1] 曾晓颖[1] 张洪娣[2] 陈玺[1] 王静文[1] 

机构地区：[1]复旦大学附属华东医院肿瘤科,上海200040 [2]复旦大学附属华东医院血液科,上海200040

出　　处：《肿瘤》2010年第9期774-777,共4页Tumor

摘　　要：目的:比较B细胞淋巴瘤老年患者与中青年患者的临床特征,并进行生存和预后分析。方法:回顾性分析初发B细胞淋巴瘤老年患者33例和中青年患者30例,接受3周类CHOP或类R-CHOP方案化疗至少6个周期。比较两组的临床特征,是否侵犯结外器官、有无B症状、血清乳酸脱氢酶(lactate dehydrogenase,LDH)水平、临床分期、体力状况评分、经年龄校正的国际预后指数(international prognostic index,IPI)、化疗和局部放疗情况。至少随访18个月,对两组患者进行生存分析和预后多因素分析。结果:老年组与中青年组的体力状况评分(P<0.000 1)、经年龄校正的IPI(P=0.002)以及化疗联合局部放疗(P=0.004)的差异,均有统计学意义;而是否侵犯结外器官、有无B症状、LDH和临床分期的差异无统计学意义。老年组患者和中青年组患者的生存时间差异无统计学意义。体力状况评分与生存时间相关(P=0.047),而性别、年龄、临床分期、LDH和有无结外器官累及均与生存时间无相关性。结论:B细胞非霍奇金淋巴瘤老年患者与中青年患者除体力状况评分、IPI和治疗方案以外,其他临床特征均相似。体力状况评分是淋巴瘤患者的预后相关因素。Objective:To compare the clinical features between elderly and young and middle-aged patients who had B-cell non-Hodgkin lymphoma and make the survival and prognosis analysis.Methods:We retrospectively analyzed the clinical data from 33 elderly patients and 30 young and middle-aged patients who were first diagnosed as having B cell non-Hodgkin lymphoma and received 3-week CHOP-like chemotherapy or at least 6 cycles of R-CHOP-like chemotherapy and compared the clinical features between the two groups.The parameters included extra lymph nodes invasion,B symptom,serum level of lactate dehydrogenase(LDH),clinical stage,performance status(PS),age-adjusted international prognostic index(IPI),chemotherapy,and local radiotherapy.The patients were given at least 6 cycles of chemotherapy and followed up for at least 18 months.The survival analysis and multivariate prognosis analysis were conducted.Results:The PS(P<0.0001),age-adjusted INI(P=0.002),and chemotherapy combined with local radiotherapy(P=0.004) had significant difference between the two groups.There was no significant difference in extra lymph nodes invasion,B symptom,serum level of LDH,and clinical stage between the two groups.The survival time was not significantly different between elderly group and young and middle-aged group.PS was associated with survival time(P=0.047),while gender,age,clinical stage,LDH level,and with or without extra organ invasion had no correlation with survival time.Conclusion:Except for PS,IPI,and therapeutic regimens,other clinical features were similar between elderly patients and young and middle-aged patients with B-cell non-Hodgkin lymphoma.PS is the prognosis-related factor for patients with B-cell non-Hodgkin lymphoma.

关 键 词：淋巴瘤 非霍奇金 老年人 存活率分析 预后 

分 类 号：R73[医药卫生—肿瘤]