绝对淋巴细胞计数在结外弥漫大B细胞淋巴瘤中的临床意义  

The clinical significance of absolute lymphocyte count in extranodal diffuse large B cell lymphoma patients

作　　者：邹志兰[1] 顾伟英[1] 王志林[1] 严峰[1] 孙冠星[1] 李青[1] 曹祥山[1] 

机构地区：[1]苏州大学附属第三医院常州市第一人民医院血液科,江苏常州213003

出　　处：《临床血液学杂志》2013年第2期173-176,共4页Journal of Clinical Hematology

摘　　要：目的:探讨结外弥漫大B细胞淋巴瘤(DLBCL)患者初发时外周血绝对淋巴细胞计数(ALC)与其临床特征的关系及对预后的影响。方法:回顾性分析初发的结外DLBCL患者的临床特征及疗效,分析不同ALC水平与结外DLBCL患者各临床特征关系及其预后的相关性。结果:本组59例结外DLBCL患者,以ALC=1.0×109/L为分界点,ALC减少组18例(ALC<1.0×109/L),ALC非减少组41例(ALC>1.0×109/L),2组性别、年龄、LDH水平、ECOG评分、IPI预后指数等临床特征差异无统计学意义(均P>0.05),但ALC减少组常伴有临床分期的升高及non-GCB型增多(均P<0.05),且临床缓解率相对较低(P<0.05);P53缺失、Bcl-6及c-myc基因的异常表达与ALC高低均无相关性(P>0.05)。结论:ALC减少可以作为结外DLBCL患者的辅助性预后判断指标。Objective：To investigate the clinical significance and prognostic value of peripheral blood absolute lymphocyte count（ALC） for patients with extranodal diffuse large B cell lymphoma at admission. Method：Clinical features,immuno-pathological type,genetic markers and therapeutic effect of 59 patients with pathologically confirmed extranodal diffuse large B cell lymphoma were retrospectively reviewed.The relationship between different ALC levels and the clinical features,immuno-pathological type,genetic markers and therapeutic effect of extranodal diffuse large B cell lymphoma patients was statistically analyzed. Result：In this study,the average age of all 59 patients with extranodal diffuse large B cell lymphoma was 61.8 years.Taking ALC=1.0×109/L as cut-off points,18 patients with lymphopenia（ALC1.0×109/L） at diagnosis were prone to manifeste with later clinical stage（P0.05） and non-GCB subtypes（P0.05）,achieving a lower rate of overall reaction rate（ORR）（P0.05） comparing with 41 cases without lymphopenia（ALC1.0×109/L）.No relationships were found between ALC level and age,gender,ECOG performance score,LDH level,IPI score,P53 gene deletion,overexpression of Bcl-6 gene or rearrangement of c-myc gene. Conclusion：Our data suggest that ALC at diagnosis is a novel,quite simple predictor of prognosis for patients with extranodal diffuse large B cell lymphoma.

关 键 词：弥漫大B细胞淋巴瘤 结外 绝对淋巴细胞绝对数 预后 

分 类 号：R733.4[医药卫生—肿瘤]