儿童非霍奇金氏淋巴瘤临床特点和远期疗效分析  

Analysis on the clinical characteristics and the long-term outcome in children with non-Hodg- kin's lymphoma

作　　者：石苇[1] 谢晓恬[1] 梁爱斌[1] 陈继莺[1] 林洁靓[1] 王耀平[2] 

机构地区：[1]同济大学附属同济医院小儿血液/肿瘤科,上海200065 [2]上海第二医科大学附属新华医院上海儿童医学中心

出　　处：《临床儿科杂志》2003年第4期214-216,共3页Journal of Clinical Pediatrics

摘　　要：探讨儿童非霍奇金氏淋巴瘤 (NHL)临床症状的多样性及远期临床疗效 ,对31例NHL(Ⅲ期16例 ,Ⅳ期15例)进行分析 ,其中初治24例 ,治疗后复发7例。对15例Ⅳ期和6例Ⅲ期T细胞型NHL应用MCP_841方案 ,8例T细胞和2例未分型Ⅲ期NHL予MCP_842方案序贯化疗 ,化疗期间采用综合防治措施治疗。结果显示 ,从首发症状出现到确诊时间为0.5～10个月 ,平均2.8个月 ;所有病列经序贯化疗后持续完全缓解 (CCR)19例 (占61.3% ) ,其中Ⅳ期6例 ,Ⅲ期13例 ;目前CCR最短1月 ,大于5年8例 ,CCR中位时间29个月 ;序贯方案中的强烈化疗方案应用后骨髓抑制明显 ,但无感染相关死亡 ,无严重出血 ,无明显肝、肾和心脏等重要脏器损伤。提示儿童NHL早期临床表现不典型 ,易误诊 ;应用MCP方案序贯治疗儿童Ⅳ和Ⅲ期NHL后 ,临床疗效较好 ,毒副反应小且可逆 ,值得临床推广。To study the diversity of initial clinical characteristics and the long_term outcome in children with advanced non_Hodgkin's lymphoma(NHL),31children were included in this study.Of them,15were in stageⅣand16in stageⅢ.24cases were first treated and7cases relapsed21children could be classified as T cell NHL(stageⅣ15cases,stageⅢ6cases)and treated with the protocol of MCP_841,others were clasˉsified as B cell NHL and treated with protocol of MCP_842.The comprehensive measures for preventing complications were taken for all children after chemotherapy.The time from initial presentation to the conˉfirmed diagnosis ranged from half a month to10months(mean time:2.8months).Up to now,19children(61.3%)still kept in the continuous complete remission state(CCR).The medium duration for CCR was29months with the longest CCR for over5years and the shortest for one month.No one died of severe infection and bleeding.The diversity of the initial presentation in children with NHL may lead to misdiagnosis.So,in suspected cases,the best way is to make biopsy as early as possible to confirm the diagnosis.The protocol of MCP_841and MCP_842were effective and had less toxicity for children with NHL.

关 键 词：儿童 非霍奇金氏淋巴瘤 临床特点 远期疗效分析 

分 类 号：R733.1[医药卫生—肿瘤]