套细胞淋巴瘤的临床特点及预后分析  

Clinical features and prognostic analysis of mantle cell lymphoma

作　　者：包维莺[1] 王焰[2] 胡喜梅[1] 李军民[2] 沈志祥[2] 赵维莅[2] 

机构地区：[1]上海交通大学医学院附属第一人民医院松江分院血液科,201600 [2]上海交通大学医学院附属瑞金医院血液科

出　　处：《中华血液学杂志》2012年第10期814-818,共5页Chinese Journal of Hematology

摘　　要：目的探讨套细胞淋巴瘤（MCL）患者的临床特点、不同治疗方案的疗效及影响预后的主要因素。方法回顾性分析2002年1月至2011年12月收治的47例MCL患者资料，并结合临床特征和治疗方案进行相关预后因素分析。结果47例患者中位发病年龄58岁，男女比例3．3：1，AnnArbor分期Ⅲ-Ⅳ期为主（42例，占89．4％）。骨髓累及者13例（27．7％），淋巴细胞绝对值升高者6例（12．8％），乳酸脱氢酶（LDH）升高者18例（38．3％）；β2-微球蛋白（β2-MG）升高者28例（59．6％）。年龄〉60岁、骨髓受累、LDH升高及治疗方案中未加用利妥昔单抗为预后不良因素。利妥昔单抗联合化疗方案有效率及完全缓解率分别为91．4％和48．6％，均优于CHOP方案（41．7％和16．7％），且在无进展生存率及总生存率方面都体现出明显优势。结论MCL患者多为老年男性，易伴骨髓受累，预后差。利妥昔单抗联合化疗可显著提高疗效及改善生存。Objective To study the clinical features, therapeutic effects, survival time and prognos- tic factors of patents with mantle cell lymphoma （MCL）. Methods Clinical data of 47 MCL patients admit- ted from January 2002 to December 2011 were retrospectively analyzed. Results Of all patients, median age was 58 year-old and male to female ratio was 3.3： 1. Forty-two cases （89.4%） were in Ann Arbor stage m -IV, 13 cases （27.7%） with bone marrow involvement, 6 cases （12.8%） with lymphocytosis, 18 cases （38.3%） with elevated LDH, and 28 cases （59.6%） with elevated 132-MG. Age, bone marrow involve- ment, increased LDH level and treatment without rituximab were poor prognostic factors. The efficiency and complete remission rate of rituximab combined with chemotherapy were 91.4% and 48.6%, which were su- perior to those of CHOP regimen （41.7% and 16.7% ）. As compared to CHOP regimen, rituximab com- bined with chemotherapy induced longer progression-free survival and overall survival. Conclusion Most pa- tients with MCL were older adults with a male predominance and usually had bone marrow involvement and poor prognosis. Rituximab combined with chemotherapy could significantly improve patient outcome.

关 键 词：淋巴瘤 非霍奇金 临床研究 利妥昔单抗 预后 

分 类 号：R733.1[医药卫生—肿瘤]