粒细胞肉瘤25例临床分析  

A Clinical Analysis of 25 Cases Granulocytic Sarcoma

作　　者：程礼敏[1] 王兆钺[1] 

机构地区：[1]苏州大学附属第一医院江苏省血液研究所卫生部血栓与止血重点实验室,江苏苏州215006

出　　处：《国际输血及血液学杂志》2013年第1期7-10,共4页International Journal of Blood Transfusion and Hematology

基　　金：江苏省临床医学中心资助项目（ZX201102）;江苏高校优势学科建设工程资助项目

摘　　要：目的探讨粒细胞肉瘤（GS）的临床特点、治疗方法及预后。方法选择2005年10月113至2012年7月3113于苏州大学附属第一医院确诊的25例GS患者为研究对象。根据患者是否进行化疗联合异基因造血干细胞移植（allo-HSCT）治疗，分为移植组（n=6）和未移植组（n=19）。回顾性分析患者的临床特点、病理特征以及治疗方法，并随访至2012年7月31日，应用Kaplan—Meier生存分析法和Log—Rank检验，比较两组患者的治疗效果及预后情况（本研究遵循的程序符合本院人体实验委员会所制定的伦理学标准，得到该伦理会批准）。结果GS好发部位为乳腺、皮肤、淋巴结等。25例GS患者中，移植组与未移植组3年总生存（OS）率分别为66．7％±27．2％和15．9％±9．5％，2组OS率比较差异有统计学意义（χ2＝7．188，P〈0．05），移植组3年OS率明显高于未移植组。结论GS临床少见，预后不良，诊断主要依靠免疫病理学试验，临床上以高剂量阿糖胞苷为主的化疗是较为有效的治疗方案，allo-HSCT有望成为一种更为积极的治疗方案，但治疗的总体效果及远期预后仍有待进一步临床观察。Objective To explore the clinical features, treatments and prognosis of granulocytic sarcoma （GS）. Methods Form 1st October 2005 to 31st July 2012, 25 patients who were diagnosed as GS in the First Affiliated Hospital of Soochow University were included in this study. All of them were divided into transplantation group （n= 6） and non-transplantation group （n = 19）, according to whether accepted the treatment of chemotherapy combined with allogeneic hematopoietic stem cell transplantation （allo- HSCT）. A retrospective analysis was made of 25 cases GS patients including the clinical characteristics, pathologic presentation, treatment and outcome. The statistic difference was tested by using Kaplan-Meier survival analysis and line of Log-Rank test. Results The predilection sites included breast, skin, lymph nodes, etc. The 3 years overall survival （OS） rate of transplantation group and non-transplantation group were 66.7%±27.2% and 15.9%±9.5%, respectively. There was a significant difference of three year OS rate between ransplantation group and non-transplantation group （χ2=7. 188,P〈0.05）. Conclusions GS is a rarely diagnosed entity, and the prognosis is generally poor. The diagnosis of GS depends on immunopathology. The therapy with high dose of cytarabine containing is a proper treatment for GS. Allo- HSCT may be a positive treatment of GS, but the benefit of the treatment and the long-term prognosis still needs to be further clinical observation.

关 键 词：粒细胞肉瘤 急性髓系白血病 异基因造血干细胞移植 

分 类 号：R733.71[医药卫生—肿瘤]