结外NK/T细胞淋巴瘤患者的临床特征及预后分析  

Analysis on Clinical Characteristics and Prognosis of 47 Patients with Extranodal NK/T Cell Lymphoma

作　　者：李其辉[1] 杨萍[1] 王继军[1] 董菲[1] 田磊[1] 万伟[1] 克晓燕[1] 景红梅[1] LI Qi-Hui;YANG Ping;WANG Ji-Jun;DONG Fei;TIAN Lei;WAN Wei;KE Xiao-Yan;JING Hong-Mei(Department of Hetnatology,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学第三医院血液科,北京100191

出　　处：《中国实验血液学杂志》2021年第1期86-90,共5页Journal of Experimental Hematology

摘　　要：目的:探讨结外NK/T细胞淋巴瘤患者的临床特点及预后的影响因素。方法:回顾性分析2009年11月至2019年11月本院收治的结外NK/T细胞淋巴瘤患者的临床资料及实验室指标同时探索影响生存和预后的因素。结果:共收集到47例具有完整临床资料的结外NK/T细胞淋巴瘤患者,中位发病年龄40(12-82)岁,男性多见男女比例为1.47:1。中位随访28(1-112)个月,5年总生存(OS)率为49.3%。ECOG评分0-1分组与≥2分组比较,5年OS率分别为51.6%和0(P=0.001);IPI评分0-1分组与≥2分组比较,5年OS率分别为60.0%和40.6%(P=0.027);淋巴瘤分期Ⅰ/Ⅱ期组与Ⅲ/Ⅳ期组比较,5年OS率分别为61.3%和31.7%(P=0.005);无B症状组与有B症状组比较,5年OS率分别为79.0%和30.1%(P=0.013);治疗前血浆中EBV-DNA <5×102/ml组与≥5×102/ml组比较,5年OS率分别为60.4%和33.3%(P=0.003);单纯化疗组、放化疗联合组及放化疗联合自体造血干细胞移植组比较,5年OS率分别为12.9%、86.5%和62.5%(P=0.001)。单因素分析结果显示,影响NK/T细胞淋巴瘤患者OS的因素有ECOG评分、IPI评分、Ann Arbor分期、B症状、血浆EBV-DNA水平和治疗模式。多因素分析结果显示,ECOG评分、B症状、血浆EBV-DNA拷贝数和治疗模式是NK/T细胞淋巴瘤OS的独立影响因素。结论:ECOG评分、B症状、EBV-DNA拷贝数、治疗模式是结外NK/T细胞淋巴瘤的独立预后因素。Objective:To investigate the clinical features and prognostic factors of patients with extranodal NK/T cell lymphoma(ENKTL).Methods:The clinical data of patients with ENKTL from November 2009 to November 2019 was collected and retrospectively analyzed to clarify the clinical features of ENKTL,and evaluate the factors that affected survival and prognosis.Results:Forty-seven patients with ENKTL were collected,median age was 40(12-82) years old,and more common in males than females,at the ratio of 1.47:1.The median follow-up was 28(1-112) months,and 5-year overall survival(OS) rate was 49.3%.The 5-year OS rates of the subjects with ECOG performance stage 0-1 and ≥2 were 51.6% and 0(P=0.001),respectively.The 5-year OS rates of International Prognostic Index(IPI)score 0-1 and ≥2 were 60.0% and 40.6%(P=0.027),respectively.The 5-year OS rates of Ann Arbor staging Ⅰ/Ⅱ and stage Ⅲ/Ⅳ were 61.3% and 31.7%(P=0.005),respectively.The 5-year OS rates of the patients with presentation of B symptoms and without presentation of B symptoms were 79.0% and 30.1%(P=0.013),respectively.The 5-year OS rates of plasma EBV-DNA level <5 × 10~2/ml and ≥5 × 10~2/ml were 60.4% and 33.3%(P=0.003),respectively.The 5-year OS rates of the patients receiving chemotherapy alone,combined chemotherapy and radiotherapy,and chemotherapy followed by autologous hematopoietic stem cell transplantation(auto-HSCT) were12.9%,86.5%,and 62.5%(P=0.001),respectively.Univariate analysis showed that ECOG score,IPI score,Ann Arbor staging,B symptoms,the copy number of EBV-DNA,and treatment regimens were statistically significant for OS.Multivariate analysis showed that ECOG score,B symptoms,the copy number of EBV-DNA,and treatment regimens were independent factors of ENKTL OS.Conclusion:ECOG score,B symptoms,the copy number of EBVDNA,and treatment regimens are independent prognostic factors for OS of patients with ENKTL.

关 键 词：NK/T细胞淋巴瘤 临床特点 预后因素 自体造血干细胞移植 

分 类 号：R733.1[医药卫生—肿瘤]