EBV阳性的老年弥漫大B细胞淋巴瘤6例临床分析  

Clinical analysis of 6 cases of EBV positive diffuse large B cell lymphoma

作　　者：张硕[1] 刘爱春[2] 于慧洋[1] 许霁虹[1] 罗洪[1] 姜明[1] 王洪敏[1] 张丽萍[1] 王立浩[1] 王占峰[1] Zhang Shuo;Liu Aichun;Yu Huiyang;Xu Jihong;Luo Hong;Jiang Ming;Wang Hongmin;Zhang Liping;Wang Lihao;Wang Zhanfeng(Department of Hematology, Qiqihar First Hospital ’Heilongjiang Qiqihar 131005,China;Department o f Hematology, HarbinMedical University Cancer Hospitaly,Heilongjiang Harbin 150081,China)

机构地区：[1]齐齐哈尔市第一医院血液科,黑龙江齐齐哈尔161005 [2]哈尔滨医科大学附属肿瘤医院血液淋巴内科,黑龙江哈尔滨150081

出　　处：《现代肿瘤医学》2016年第14期2299-2302,共4页Journal of Modern Oncology

摘　　要：目的:分析EBV阳性的老年弥漫大B细胞淋巴瘤临床特点。方法:采用EBV编码微小RNA(EBVeucdedmiRNA，EBERS)原位杂交检测方法确定EBV感染的老年弥漫大B细胞淋巴瘤6例。结果：例患者中男、女各3例;中位发病年龄为59.2(50~66)岁；疾病分期在n期的有3例，IV期3例;IPI评分<2分的患者有3例，&2分的患者3例;有B症状的患者3例，无B症状的患者3例;ECOG<2分的患者4例，ECOG&2分的患者2例;LDH升高的患者3例，LDH正常的患者3例。生发中心外的患者3例，生发中心内的患者3例;CD30阳性的患者5例,CD30阴性的患者（例。原发于淋巴结外的患者有5例,原发于淋巴结的患者1例。6例患者治疗均采用CHOP样方案，其中1例应用R-CHOP方案化疗6周期，疾病达PR，（例应用CHOP方案化疗6周期，疾病达CR,2个月后疾病进展，给予放疗及CHOP方案化疗2周期效果不佳死亡，1例应用R-CHOP方案化疗4周期，疾病完全缓解后应用R单药维持治疗，（例应用R-CHOP方案化疗4周期疾病达PR,再次给予R-CHOPE方案治疗后疾病快速进展死亡，（例应用CHOPE方案化疗5周期后疾病达PR,1例应用R-CHOP方案化疗2周期后放疗疾病进展死亡。上述病例死亡3例，部分缓解2例，完全缓解（例，中位生存时间为10个月。结论:EBV阳性的老年弥漫大B细胞淋巴瘤患者发病率较低，对治疗的敏感性差，即使疾病达到完全缓解亦很快进展死亡,且常以淋巴结结外侵犯为主，伴有CD30阳性，本实验由于病例有限，仍需多家中心联合统计，进一步探究治疗EBV阳性的老年弥漫大B细胞淋巴瘤具有针对性的有效治疗方案,最大程度的改善患者预后。Objective:To analyze the clinical characteristics of EBV positive diffuse large B cell lymphoma in eld?erly patients. Methods:EBV RNA (encoded miRNA EBV,EBERs) in situ hybridization was used to determine the EBV infection in aged patients with diffuse large B cell lymphoma in 6 cases. Results:In 6 patients 3 were males and 3 females,median age was 59.2 (50 ?66 years),disease staging in phase II was in 3 cases, 3 cases stage IV. IPI score <2 in 3 cases,IPI score greater than or equal to 2 in 3 cases. B symptoms in 3 cases,3 cases without B symp?toms. ECOG <2 in 4 patients,2 cases with ECOG more than or equal to 2,and biochemical indexes:Elevated LDH in three cases,normal LDH patients in 3 cases. In 3 patients with germinal centers,3 patients were in the center of the germinal center. 5 patients were CD30 positive, 1 was CD30 negative. Primary site : 5 cases with lymph nodes ( 1 case) ,the patients with the primary lymph nodes. 6 cases were treated with CHOP scheme,in which 1 case of applica?tion of R - CHOP chemotherapy 6 cycles, got partial remission, 1 case with CHOP regimen for 6 cycles, we re CR,2 months after disease progression,giving radiotherapy and CHOP chemotherapy 2 cycles ineffective died. 1 case with R - CHOP chemotherapy,4 cycles, got complete remission after application R maintenance monotherapy, and 1 casewith R - CHOP chemotherapy 4 cycle got PR, giving R - CHOPE regimen but was rapid progress and dead. 1 caseused CHOPE regimen 5 cycles PR. 1 case used R - CHOP chemotherapy 2 cycles of radiotherapy and progress anddead. Median survival time was 10 months. Conclusion:The incidence of EBV positive DLBCL patients is lower,andthe sensitivity to treatment is poor,even if the disease reaches CR,it is also very fast,and it is usually associated withCD30 positive. This experiment is limited. It is still necessary to explore the effective treatment for EBV positive DL-BCL.

关 键 词：EB病毒 老年 弥漫大B细胞淋巴瘤 临床特点 

分 类 号：R733.4[医药卫生—肿瘤]