血管免疫母细胞性T细胞淋巴瘤20例临床分析  

Clinical analysis of 20 patients with angioimmunoblastic T-cell lymphoma

作　　者：郭智[1] 何学鹏[1] 杨凯[1] 刘晓东[1] 陈鹏[1] 刘兵[1] 刘丹[1] 王丙然[1] 陈惠仁[1] 

机构地区：[1]北京军区总医院血液科,100700

出　　处：《白血病．淋巴瘤》2012年第1期42-46,共5页Journal of Leukemia & Lymphoma

摘　　要：目的分析血管免疫母细胞性T细胞淋巴瘤（AILT）的临床特点及近期疗效，为提高AILT诊治水平提供借鉴。方法对2005年1月至2010年1月收治的20例AILT患者的临床资料进行回顾性分析，总结患者的临床及病理特点、治疗和生存情况。结果20例AILT患者中位年龄55．9岁，均有淋巴结肿大，11例有B组症状，确诊依据淋巴结活组织检查，免疫组织化学均表达T细胞抗原CD3、CD45RO，治疗均采用以CHOP方案为主的化疔，其他治疗包括DICE、ESHAP、Hyper—CVAD方案及自体造血干细胞移植，随访5—69个月，全组中位生存期为20．2个月（5～69个月），1、2、3年无病生存率分别为67％、33％、11％，8例处于持续缓解状态，占全组的40％，分别生存63、47、27、24、24、12、5、1个月。结论AILT患者年龄偏大，化疗过程中并发症较多，虽然早期化疗可使患者症状有不同程度减轻，但停止治疗后容易复发，国际预后指数（IPI）对长期生存的影响非常重要，临床需要更有效的治疗方案来提高AILT的疗效。Objective To improve the diagnosis efficiency of patients with angioimmunoblastic T-cell lymphoma （AILT） by analyzing the clinical characteristics and curative effect of AILT. Methods Retrospective studies were used on clinicopathological features, immunophenotypes, treatment and survival of 20 angioimmunoblastic T-cell lymphoma patients, who were collected between January 2005 and January 2010 of Beijing Military General Hospital. Results In the 20 patients receiving chemotherapy,the median age was 55.9 years old. All of the 20 had lymph nodes and 11 of whom were accompanied with B group of symptoms, which were confirmed by lymph node biopsy and T cell antigen CD3, CD45RO positive expression in all the patients. ALL of the patients received the CHOP regimen and combining with other treatment such as DICE, ESHAP, Hyper-CVAD or autologous hematopoietic stem cell transplantation. A follow-up by 5 to 69 months showed that median survival was 20.2 （5-69） months and 1, 2, and 3-year disease free survival （DFS） were 67 %, 33 %, and 11% respectively. 8 patients of the group （40 %） with a sustained remission （CCS） respectively survived 63, 47, 27, 24, 24, 12, 5, 1 months so far. Conclusion Most patients were older with many complications during chemotherapy, which resulted in easy relapse, and even the symptoms were alleviated at the early stage of the chemotherapy. IPI prognostic index is more important with long-term survival in AITL. Therefore further studies are required to improve the outcome.

关 键 词：免疫母细胞淋巴结病 治疗结果 无病生存 

分 类 号：R733.1[医药卫生—肿瘤]