套细胞淋巴瘤15例临床特征及疗效观察  

Clinical features and therapeutic effect of 15 mantle cell lymphoma patients

作　　者：肖秀斌[1] 仲凯励[1] 赵世华[1] 鲁云[1] 达永[1] 马艺[1] 刘静[1] 陈喜林[1] 张伟京[1] 苏航[1] 

机构地区：[1]军事医学科学院附属医院,北京100071

出　　处：《军事医学》2015年第11期859-862,共4页Military Medical Sciences

摘　　要：目的：探讨套细胞淋巴瘤（mantle cell lymphoma，MCL）临床特征及常规治疗后近期疗效。方法回顾性分析军事医学科学院附属医院2004年8月至2013年10月收治的15例 MCL 患者的临床资料。结果患者中位发病年龄59岁，男女比例1．5∶1，Ann-Arbor 分期Ⅲ～Ⅳ期14例（93％）；病灶累及淋巴结15例（100％）、骨髓7例（47％）、胃肠道4例（27％）、眼眶3例（20％）。免疫组化 Ki-67阳性率＜40％的9例（60％），≥40％的6例（40％）；母细胞型1例。一线治疗以 CHOP 方案为主，其中8例联合利妥昔单抗。患者中位生存期12个月（3～64个月），诱导化疗后总有效率80％。Ki-67＜40％组存活7／9例，迄今已生存8～64个月；Ki-67≥40％组存活2／6例，至今已分别生存8、9个月。结论MCL 多发于老年男性，临床生物学行为具有侵袭性，常结外受侵，目前常规化疗疗效有限，形态学表现为母细胞分化、Ki-67高表达的患者预后不佳。Objective To analyze the clinical characteristics and recent curative effect of mantle cell lymphoma （MCL） after conventional treatment.Methods Clinical data of 15 MCL patients admitted in the Affiliated Hospital of Academy of Military Medical Sciences between August 2004 and October 2013 were retrospectively analyzed.Results The median age of those patients was 59 and the male to female ratio was 1.5∶1.Fourteen（93%）cases were in Ann-Arbor stages Ⅲ -Ⅳ, 15 cases （100%）primarily with lymph node involvement,7 cases （47%）with bone marrow involvement,4 cases （27%）with gastrointestinal involvement,and 3 cases （20%）with orbit involvement.Less than 40% expression of Ki-67 was observed in 9 cases （60%）,while 6 cases were with more than 40% （40%）.One case was blastic variant.First-line therapy was CHOP-like regimens,which were combined with rituximab in 8 of the 15 cases.In this study,the median survival time was 12 months （3 -64）,and the overal response rate was 80%after induction chemotherapy.The current survival of 7 /9 cases with less than 40% expression of Ki-67 was 8 -64 months,2 /6 cases with more than 40% expression of Ki-67 was 8 and 9 months,respectively.Conclusion MCL mostly occurs in older males.Extranodal invasion is common in MCL as an aggressive tumor.The efficacy of traditional chemotherapy is currently limited.Blastic variant or high expression of Ki-67 is an adverse prognostic indicator.

关 键 词：套细胞淋巴瘤 化学疗法 辅助 预后 KI-67 抗原 

分 类 号：R733.1[医药卫生—肿瘤]