初诊时伴嗜酸粒细胞增多的外周T细胞淋巴瘤15例  

Peripheral T-cell lymphoma with eosinophilia at initial diagnosis:15 cases report

作　　者：宋明月 刘沁华[2] 丁刚[1] 吴燕明[1] SONG Mingyue;LIU Qinhua;DING Gang;WU Yanming(Department of Hematology,Chaohu Hospital Affiliated to Anhui Medical University,Chaohu,Anhui 238000,China;Department of Hematology,The First Affiliated Hospital of Anhui Medical University,Hefei,Anhui 230022,Chin)

机构地区：[1]安徽医科大学附属巢湖医院血液科,安徽巢湖238000 [2]安徽医科大学第一附属医院血液科,安徽合肥230022

出　　处：《安徽医药》2022年第6期1193-1196,I0005,共5页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨伴嗜酸粒细胞(EOS)增多的外周T细胞淋巴瘤(PTCL)的发病机制、临床特点及治疗措施。方法分析安徽医科大学附属巢湖医院2018年7月收治的1例及国内外近5年文献报道确诊的14例伴EOS增多的PTCL病人的临床资料,探讨该病的发病机制、临床特点及治疗和预后。结果15例病人中高龄者多见,Ann Arbor分期晚,结外有多处组织侵犯,大多数国际预后指数(IPI)评分位于中高危组。除1例失访外,化疗组(n=12)总生存时间[10.00(6.50,32.13)个月]与对症治疗组(n=2)总生存时间(分别为11.00个月,14.00个月)相比,差异无统计学意义(P>0.05);一线方案化疗组(n=10)总生存时间[10.00(7.50,26.37)个月]与二线方案化疗组(n=2)总生存时间(分别为2.50个月,50.00个月)相比,差异无统计学意义(P>0.05);一线与二线方案化疗组1年累计生存率(40%比50%),差异无统计学意义(P>0.05)。结论伴EOS增多的PTCL病人临床上较为罕见,极易误诊和漏诊,远期预后不佳。自体干细胞移植(ASCT)作为PTCL诱导缓解后的巩固治疗可大幅度提高病人的生存率,相较于单纯化疗疗效更佳。Objective To explore the pathogenesis,clinical features and treatment of peripheral T cell lymphoma(PTCL)with eosinophilia(EOS).Methods The clinical data of 1 case admitted to Chaohu Hospital Affiliated to Anhui Medical University in July 2018 and 14 cases of PTCL patients with increased EOS reported in literatures at home and abroad in recent 5 years were analyzed.Results Most of the 15 patients were elderly,with late Ann Arbor stage and multiple extranodal tissue invasion.Most of the international prognostic index(IPI)scores were in the medium-high risk group,and multiple extra-junction tissues or organs were invaded with late Ann Arbor stage and most in high-risk group of international prognosis index(IPI).Except for 1 lost case,there was no significant difference in OS between the chemotherapy group(n=12)[10.00(6.50,32.13)]months,and symptomatic treatment group(n=2)(11.00 months and 14.00 months)(P>0.05).There was no significant difference in OS between the first-line(n=10)[10.00(7.50,26.37)]months and the second-line(n=2)(2.50 months and 50.00 months)of chemotherapy group(P>0.05).Kaplan Meier survival curve showed that there was no significant difference in mortality risk between the first-line(40%)and the second-line(50%)of chemotherapy group(P>0.05).Con⁃clusions PTCL patients with eosinophils are rare,easily be misdiagnosed and missed in clinic with a poor long-term prognosis.Autologous stem cell transplantation as a consolidation therapy of after PTCL induced remission can significantly improve the survival rate of patients,and is more effective than chemotherapy alone。

关 键 词：淋巴瘤 T细胞 外周 嗜酸粒细胞增多 抗肿瘤联合化疗方案 

分 类 号：R733.1[医药卫生—肿瘤]