CAJ | 학술논문

目的：本文旨在对“双击”B细胞淋巴瘤（double-hit B-cell lymphoma，DHL）和“三击”B细胞淋巴瘤（triple-hit B-cell lymphoma，THL）的诊断及治疗分析，以期提高对该类淋巴瘤的认识，为其诊治提供临床经验。方法：对2011年1月至2012年12月本院收治的3例滤泡细胞性淋巴瘤（follicular lymphoma，FL）转化的“双击”或“三击”B细胞淋巴瘤病例进行分析，3例患者均经免疫组织化学、荧光染色体原位杂交（fluorescence in situ hybridization，FISH）检测诊断明确。结果：1例“三击”患者3个月后死亡，2例经R-CHOP，R-ESHAP等方案化疗仍未达到完全缓解。结论：“双击”淋巴恶性程度高，多伴有中枢神经系统、骨髓等髓外病变，病程呈侵袭性，部分病例由滤泡细胞淋巴瘤转化而来，对化疗不敏感，患者预后差，FISH检测是诊断该病的重要手段，目前尚无标准治疗方案。
목적：본문지재대“쌍격”B세포림파류（double-hit B-cell lymphoma，DHL）화“삼격”B세포림파류（triple-hit B-cell lymphoma，THL）적진단급치료분석，이기제고대해류림파류적인식，위기진치제공림상경험。방법：대2011년1월지2012년12월본원수치적3례려포세포성림파류（follicular lymphoma，FL）전화적“쌍격”혹“삼격”B세포림파류병례진행분석，3례환자균경면역조직화학、형광염색체원위잡교（fluorescence in situ hybridization，FISH）검측진단명학。결과：1례“삼격”환자3개월후사망，2례경R-CHOP，R-ESHAP등방안화료잉미체도완전완해。결론：“쌍격”림파악성정도고，다반유중추신경계통、골수등수외병변，병정정침습성，부분병례유려포세포림파류전화이래，대화료불민감，환자예후차，FISH검측시진단해병적중요수단，목전상무표준치료방안。
Objective: To analyze the diagnosis and therapy for double-hit lymphoma (DHL) and triple-hit lymphoma (THL). Methods:This study involves three patients with follicular lymphoma (FL) that transformed into DHL or THL. These patients were ad-mitted to our hospital between January 2011 and December 2012. All patients were diagnosed by immunohistochemistry and fluores-cence in situ hybridization (FISH). Results:One FL patient transformed into THL and died after 3 months. The other two FL patients who transformed into DHL and who received R-CHOP and R-ESHAP regimens still failed to achieve complete remission. Conclusion:DHL is a rare type of lymphoma that usually involves the bone marrow and central nervous system. This condition is highly resistant to intensive chemotherapy. Part of the DHL cases result from FL. FISH is important for diagnosis. However, a standard treatment for this type of lymphoma remains lacking.