43例淋巴母细胞淋巴瘤患者临床特点及疗效分析  

Analysis of clinical feature and treatment outcome in 42 patients with lymphoblastic lymphoma

作　　者：鲁云 李倩 邹德慧 赵耀中 齐军元 徐燕 邱录贵 

机构地区：[1]中国医学科学院、北京协和医学院血液学研究所、血液病医院,实验血液学国家重点实验室

出　　处：《中华血液学杂志》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）

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.

关 键 词：淋巴瘤 淋巴母细胞 疾病特征 治疗结果 

分 类 号：R686[医药卫生—骨科学]