T淋巴母细胞淋巴瘤临床特征及预后分析  

Clinical characteristics and prognosis analysis of T-lymphoblastic lymphoma

作　　者：李熙宇 张敏[2] 张晶晶 杨春燕[2] 黄倩[2] 王海燕[2] 贾路 陈璐璐[2] 张颢[2] Li Xiyu;Zhang Min;Zhang Jingjing;Yang Chunyan;Huang Qian;Wang Haiyan;Jia Lu;Chen Lulu;Zhang Hao(Clinical Medical College,Jining Medical University,Jining 272029,China;Department of Hematology,Affiliated Hospital of Jining Medical University,Jining 272029,China)

机构地区：[1]济宁医学院临床医学院,济宁272029 [2]济宁医学院附属医院血液科,济宁272029

出　　处：《白血病.淋巴瘤》2025年第1期30-33,共4页Journal of Leukemia & Lymphoma

基　　金：山东省自然科学基金面上项目(ZR2021MH320)。

摘　　要：目的探讨T淋巴母细胞淋巴瘤(T-LBL)的临床特征及预后。方法回顾性病例系列研究。回顾性分析2013年1月至2023年3月济宁医学院附属医院诊断为T-LBL患者的临床资料,对其临床特征及预后情况进行统计分析。结果共纳入T-LBL患者22例,其中男性19例(86.4%),女性3例(13.6%);发病中位年龄19.5(15,28)岁;根据Ann Arbor分期Ⅰ~Ⅱ期3例(13.6%),Ⅲ~Ⅳ期19例(86.4%);有B症状10例(45.5%),无B症状12例(54.5%);乳酸脱氢酶(LDH)升高者16例(72.7%)。发病时合并纵隔包块7例(31.8%),3例(13.6%)患者在诊断时中枢神经系统受累,17例(77.3%)骨髓受累。22例患者总有效率(ORR)为81.82%(18/22),完全缓解率31.82%(7/22)。19例接受ALL样治疗方案患者ORR为84.21%(16/19)。3例接受NHL样治疗方案患者达完全缓解和部分缓解各1例。7例接受异基因造血干细胞移植,中位总生存(OS)时间为22个月;未接受异基因造血干细胞移植患者中位OS时间为14个月。异基因造血干细胞移植组与未进行异基因造血干细胞移植组3年OS率分别为64.30%、16.00%,两组OS比较,差异有统计学意义(P=0.043)。2例移植前为疾病进展患者,移植后死于多重耐药菌感染。结论T-LBL少见,好发于青少年男性,具有高度侵袭性。异基因造血干细胞移植能延长OS,减少复发,改善患者的预后。Objective To investigate the clinical characteristics and prognosis of T-lymphoblastic lymphoma(T-LBL).Methods A retrospective case series study was conducted.Clinical data of patients diagnosed with T-LBL at the Affiliated Hospital of Jining Medical University from January 2013 to March 2023 were retrospectively analyzed,and their clinical characteristics and prognosis were statistically analyzed.Results A total of 22 T-LBL patients were included.Among them,there were 19 males(86.4%)and 3 females(13.6%),and the median age at onset was 19.5(15,28)years old.Based on Ann Arbor staging,3 cases(13.6%)were classified as stageⅠ-Ⅱ,while 19 cases(86.4%)were stageⅢ-Ⅳ;10 cases(45.5%)presented with B symptoms,12 cases(54.5%)without B symptoms;16 cases(72.7%)showed elevated lactic dehydrogenase(LDH)level.At onset,7 patients(31.8%)had mediastinal masses,3 patients(13.6%)had central nervous system involvement,and 17 patients(77.3%)had bone marrow involvement.The overall response rate(ORR)and complete remission rate among the 22 patients were 81.82%(18/22)and 31.82%(7/22),respectively.The ORR was 84.21%(16/19)in 19 patients treated with ALL-like regimens.Among 3 patients treated with NHL-like regimens,1 case achieved complete remission and 1 case achieved partial remission.Seven patients received allogeneic hematopoietic stem cell transplantation,with a median overall survival(OS)time of 22 months;the median OS time of patients without allogeneic hematopoietic stem cell transplantation was 14 months.The 3-year OS rates in the allogeneic hematopoietic stem cell transplantation group and group without allogeneic hematopoietic stem cell transplantation were 64.30%and 16.00%,and the difference in OS between the two groups was statistically significant(P=0.043).Two patients with disease progression prior to transplantation died of multidrug-resistant bacterial infections after transplantation.Conclusions T-LBL is rare,and it is a highly aggressive tumor that predominantly occurs in adolescent males.Allogeneic hematopoietic s

关 键 词：T细胞淋巴瘤 异基因造血干细胞移植 预后 

分 类 号：R733.1[医药卫生—肿瘤]