介于DLBCL/BL未分类B细胞淋巴瘤的临床病理特点、治疗与预后分析  

Analysis of the Clinicopathological Characteristics,Treatment and Prognosis of Unclassifiable B-Cell Lymphoma Intermediated between DLCBL and BL

作　　者：刘德亮[1] 王彪[1] 朱远东[1] 严峰[1] LIU De-Liang, WANG Biao, ZHU Yuan-Dong, YAN Feng(Department of Hematology, Changzhou First People＇s Hospital, Changzhou 213003, Jiangsu Province, Chin)

机构地区：[1]常州市第一人民医院血液科,江苏常州213003

出　　处：《中国实验血液学杂志》2018年第2期443-448,共6页Journal of Experimental Hematology

摘　　要：目的:分析介于DLBCL/BL未分类B细胞淋巴瘤的临床病理特点、治疗与预后。方法:收集本院2014年7月至2016年6月16例DLBCL/BL患者的全部临床资料及病理资料,采用寿命表法进行总生存及无事件生存分析,采用Kaplan-Meier法进行组间生存比较,应用Log-rank检验对年龄、性别、IPI评分、肿瘤分期、B症状、肿瘤细胞来源、KPS评分、DPL、β2微球蛋白水平、治疗前LDH水平、初治化疗方案强度等因素进行单因素分析。结果:16例患者中出现淋巴结外侵犯的患者有15例,中位总生存时间为11个月,1年总生存率为50.0%;中位无事件生存时间为7个月,1年无事件生存率为43.8%。高强度化疗方案与CHOP或CHOP样方案治疗患者间生存差异无统计学意义(P=0.067)。IPI评分在3分以上和治疗前LDH异常升高为预后独立危险因素。结论:DLBCL/BL是一种高度恶性的肿瘤,生存期短,高强度化疗方案较CHOP或CHOP样方案更能改善患者生存,其预后独立危险因素是IPI评分在3分以上及治疗前LDH异常升高。Objective： To analyze the clinicopathological characteristics, treatment and prognosis of patients with unclassifiable B-cell lymphoma intermediated between DLCBL and BL. Methods： A total of 16 patients with DLBCL/ BL in our hospital were included in this study between July 2014 and June 2016. The clinical and pathological data of 16 patients were collected. Kaplan-Meier method was used to estimate and compare overall survival （OS） and progression- free survival （PFS）. The log-rank test was used to analyze the influence of age, sex, B symptoms, LDH level, lymyhoma staging, KPS score, Ki-67 （ % ）, extranodal sites, IPI score, β2 microglobulin level, DPLs, tumour cell origin and treatment etc. Results： Fifty out of 16 patients showed extra-nodal involvement among the 16 patients with DLBCL/BL. The median OS and PFS times were 11 and 7 months respectively. The one year OS and PFS rates were 50.0% and 43.8% respectively. The borderline difference between the CHOP, CHOP - like, and intensive chemotherapy groups is statistically significant （ P = 0. 067 ）. Univariate analysis showed that IPI score and LDH were significant prognostic factors for the overall survival of the patients with DLBCL/BL. Conclusion： DLBCL/BL is a highly aggressive B-cell lymphoma with a short survival time. DLBCL/BL responded better to intensive chemotherapy than CHOP or CHOP-like regimen. IPI score and LDH level are significant prognostic factors for the overall survival of the patients with DLBCL/BL.

关 键 词：未分类B细胞淋巴瘤 伯基特淋巴瘤 弥漫大B细胞淋巴瘤 

分 类 号：R733.1[医药卫生—肿瘤]