血管内大B细胞淋巴瘤17例临床分析  

Intravascular Large B-cell Lymphoma:a Clinical Analysis of 17 Cases

作　　者：杨晋军 陈心传[1] 唐韫[1] 沈凯 谢丽萍[1] 刘霆[1] 

机构地区：[1]四川大学华西医院血液内科,成都610041 [2]成都市第二人民医院心血管内二科,成都610041

出　　处：《四川大学学报（医学版）》2018年第1期145-147,共3页Journal of Sichuan University(Medical Sciences)

摘　　要：目的分析血管内大B细胞淋巴瘤的临床特点、治疗及预后。方法回顾性分析四川大学华西医院血液科2009年2月至2015年7月诊治的17例血管内大B细胞淋巴瘤患者的临床资料,并进行生存分析。结果纳入患者17例,男10例,女7例,发病年龄24~83岁,平均53岁;反复发热是患者最常见的首发症状(76.5%),骨髓是最易累及的部位(64.7%),临床分期多为ⅣB期(70.6%),常合并噬血细胞综合征(29.4%)。R-CHOP(利妥昔单抗、环磷酰胺、表阿霉素、长春地辛、强的松)或CHOP方案化疗(10例)可以显著改善患者的生存时间(与未治疗的7例患者相比,P=0.000 2)。骨髓受累的患者治疗后易复发。结论血管内大B细胞淋巴瘤侵袭性强,预后差。R-CHOP方案化疗可以显著改善患者的预后,治疗后获得完全缓解的患者进行自体造血干细胞移植,可能在长期生存上获益。Objective To analyze the clinical features, response to therapy and prognosis of intravascular large B-cell lymphoma （IVLBCL）. Methods The clinical data of 17 cases with IVLBCL were retrospectively reviewed, and survival analysis was conducted. Results The study involved 10 males and 7 females of IVLBCL with a mean age of 53 years old. The most common symptom of the disease was recurrent fever （76.5%）. The lymphoma was mainly observed in bone marrow （64. 7%） and was clinically determined as stage ⅣB （70. 6%）. Many of the patients were also diagnosed with the hemophagocytic syndrome （29.4%）. R-CHOP （rituximab, cyclophosphamide, epirubicin, vindesine, prednisone） or CHOP regimen chemotherapy significantly improved the survival of the patients （P=0. 000 2）. Unfortunately, those patients with bone marrow involvement were prone to relapse after treatment. Conclusion IVLBCL is highly invasive and associated with poor prognosis. R-CHOP chemotherapy can significantly improve the prognosis.

关 键 词：血管内大B细胞淋巴瘤 利妥昔单抗 噬血细胞综合征 临床分析 

分 类 号：R733.1[医药卫生—肿瘤]