66例套细胞淋巴瘤15年临床特征及治疗预后分析  

Clinical Characteristics and Outcome of 66 Cases of Mantle Cell Lymphomas

作　　者：毋艳[1] 王慧[1] 刘晓娟[1] 王彦艳[2] 赵维莅[2] 李军民[2] 沈志祥[2] 

机构地区：[1]焦作市第二人民医院血液科,河南焦作454150 [2]上海交通大学医学院附属瑞金医院血液科,上海200025

出　　处：《中国实验血液学杂志》2017年第4期1036-1041,共6页Journal of Experimental Hematology

摘　　要：目的:研究套细胞淋巴瘤(MCL)患者的临床特点及预后相关因素。方法:回顾性分析2000年1月至2014年12月在上海交通大学医学院附属瑞金医院血液科住院治疗的66例M CL患者的临床特点,评价各化疗方案的疗效及预后。结果:66例患者男女比例3.71∶1,发病中位年龄为59岁,Ann Arbor分期以Ⅲ-Ⅳ为主(90.9%)。R-Hyper CVAD化疗方案的CR率最高,达到55.6%,其次为R-CHOP方案,CR率为44.4%。预期5年OS为35.5%±11.5%,预期5年PFS为8.8%±5.6%。患者起病时WBC异常(>10×109/L或<4×109/L),LDH异常,骨髓受累及,Ki-67指数,是否合并B症状,发病时M IPI分期是否为高危组及治疗过程中是否联合利妥昔单克隆抗体治疗均为MCL患者的独立预后因素。结论:MCL患者预后较差,多见于男性,易累及骨髓及胃肠道等结外部位,联合利妥昔单克隆抗体可以改善患者的生存及预后。Objective： To analyze the clinical features and prognostic factors of patients with mantle cell lymphoma（ MCL）. Methods： The clinical data of 66 MCL patients were collected from the Department of Hematology of Shanghai Ruijin Hospital,Shanghai Jiaotong University Medical School from January 2000 to December 2014. The clinical characteristics,treatment efficiency and survival rate were analyzed retrospectively. Results： The sex ratio of male to female in these 66 MCL patients was 3. 71∶ 1,the nosopoietic median age was 59 years old, and most cases were diagnosed as MCL in Ann Arbor stage Ⅲ-Ⅳ（ 90. 9%）. ＂R-HperCVAD＂ regimen had the highest CR-rate reached to55. 6%,and CR rate of ＂R-CHOP＂ reached to 44. 4%. The total prospective 5-year overall survival and progress-free survival rates were 35. 5% ± 11. 5% and 8. 8% ± 5. 6%,respectively. Leukocyte count abnormality（ 10 × 109/L or 4 × 109/L）,B symptom,LDH level,bone marrow involvement,Ki-67 and high risk group of MIPI scores,and therapy combined with or without rituximab were the independent prognostic factors. Conclusion： The prognosis of MCL patients is poor,and the incidence is higher in men. The extranodal sites of bone marrow and gastrointestinal tract are involved more easily. The treatment combined with rituximab can increase survival rate for these patients.

关 键 词：淋巴瘤 非霍奇金 临床特征 利妥昔单抗 预后 

分 类 号：R733.1[医药卫生—肿瘤]