中华肿瘤杂志
中華腫瘤雜誌
중화종류잡지
CHINESE JOURNAL OF ONCOLOGY
2014年
12期
928-932
,共5页
周萍%石远凯%何小慧%周生余%刘鹏%董梅%秦燕%杨建良%张长弓
週萍%石遠凱%何小慧%週生餘%劉鵬%董梅%秦燕%楊建良%張長弓
주평%석원개%하소혜%주생여%류붕%동매%진연%양건량%장장궁
淋巴瘤,膜细胞%临床特征%生存,无病%预后
淋巴瘤,膜細胞%臨床特徵%生存,無病%預後
림파류,막세포%림상특정%생존,무병%예후
Lymphoma,mantle-cell%Clinical feature%Disease-free survival%Prognosis
目的 探讨套细胞淋巴瘤(MCL)患者的临床特征、疗效和预后影响因素.方法 回顾性分析2003年8月至2013年6月中国医学科学院肿瘤医院收治的68例MCL患者的临床特征和不同治疗方案的疗效,并进行预后相关因素分析.结果 68例MCL患者中位发病年龄58.5岁,男女比例为2.8∶1,Ann Arbor分期以Ⅲ～Ⅳ期为主(占86.8％).首发于淋巴结者56例,累及淋巴结外器官者49例,其中骨髓受侵19例.采用CHOP样方案化疗患者的客观缓解率为80.5％,明显高于采用加强方案化疗的患者(57.9％,P =0.036).68例MCL患者的中位随访时间为35个月,3年和5年总生存率分别为78.5％和64.1％,中位无进展生存时间为20.0个月,2年和3年无进展生存率分别为41.3％和23.7％.单因素分析显示,Ⅲ～Ⅳ期、IPI评分为3～5分、Ki-67≥30％、乳酸脱氢酶(LDH)水平升高、β2-微球蛋白水平升高、伴母细胞转化、受累淋巴结数≥5个、近期疗效评价为无效的患者无进展生存时间明显缩短.多因素分析显示,Ki-67指数、LDH水平和化疗疗效为影响患者无进展生存的独立预后因素.结论 MCL多见于老年男性,发病率低,分期较晚,骨髓受累较常见.CHOP样方案治疗MCL比加强方案的客观有效率高,但预后仍较差.
目的 探討套細胞淋巴瘤(MCL)患者的臨床特徵、療效和預後影響因素.方法 迴顧性分析2003年8月至2013年6月中國醫學科學院腫瘤醫院收治的68例MCL患者的臨床特徵和不同治療方案的療效,併進行預後相關因素分析.結果 68例MCL患者中位髮病年齡58.5歲,男女比例為2.8∶1,Ann Arbor分期以Ⅲ～Ⅳ期為主(佔86.8％).首髮于淋巴結者56例,纍及淋巴結外器官者49例,其中骨髓受侵19例.採用CHOP樣方案化療患者的客觀緩解率為80.5％,明顯高于採用加彊方案化療的患者(57.9％,P =0.036).68例MCL患者的中位隨訪時間為35箇月,3年和5年總生存率分彆為78.5％和64.1％,中位無進展生存時間為20.0箇月,2年和3年無進展生存率分彆為41.3％和23.7％.單因素分析顯示,Ⅲ～Ⅳ期、IPI評分為3～5分、Ki-67≥30％、乳痠脫氫酶(LDH)水平升高、β2-微毬蛋白水平升高、伴母細胞轉化、受纍淋巴結數≥5箇、近期療效評價為無效的患者無進展生存時間明顯縮短.多因素分析顯示,Ki-67指數、LDH水平和化療療效為影響患者無進展生存的獨立預後因素.結論 MCL多見于老年男性,髮病率低,分期較晚,骨髓受纍較常見.CHOP樣方案治療MCL比加彊方案的客觀有效率高,但預後仍較差.
목적 탐토투세포림파류(MCL)환자적림상특정、료효화예후영향인소.방법 회고성분석2003년8월지2013년6월중국의학과학원종류의원수치적68례MCL환자적림상특정화불동치료방안적료효,병진행예후상관인소분석.결과 68례MCL환자중위발병년령58.5세,남녀비례위2.8∶1,Ann Arbor분기이Ⅲ～Ⅳ기위주(점86.8％).수발우림파결자56례,루급림파결외기관자49례,기중골수수침19례.채용CHOP양방안화료환자적객관완해솔위80.5％,명현고우채용가강방안화료적환자(57.9％,P =0.036).68례MCL환자적중위수방시간위35개월,3년화5년총생존솔분별위78.5％화64.1％,중위무진전생존시간위20.0개월,2년화3년무진전생존솔분별위41.3％화23.7％.단인소분석현시,Ⅲ～Ⅳ기、IPI평분위3～5분、Ki-67≥30％、유산탈경매(LDH)수평승고、β2-미구단백수평승고、반모세포전화、수루림파결수≥5개、근기료효평개위무효적환자무진전생존시간명현축단.다인소분석현시,Ki-67지수、LDH수평화화료료효위영향환자무진전생존적독립예후인소.결론 MCL다견우노년남성,발병솔저,분기교만,골수수루교상견.CHOP양방안치료MCL비가강방안적객관유효솔고,단예후잉교차.
Objective To analyze the clinical features,therapeutic outcome and prognostic factors of mantle cell lymphoma (MCL).Methods Clinical data of a total of 68 patients with MCL admitted from August 2003 to June 2013 in our department were retrospectively analyzed.Results Of all the patients,the median age was 58.5 years,with marked male predominance (2.8∶1),59 patients (86.8％) were in Ann Arbor stage Ⅲ/Ⅳ.56 cases (82.4％) primarily showed lymph node involvement,49 cased showed extranodal involvement and 19 cases (38.8％) had bone marrow involvement.Patients were followed up for 4 to 122 months with a median follow up time of 35 months.The 3-and 5-year overall survival (OS) rates were78.5％ and 64.1％,respectively.The 2-and 3-year progression-free survival (PFS) rates were 41.3％ and 23.7％,respectively,and the median time to progression was 20.0 months.The overall response rate (ORR) of CHOP regimen was superior to that of intense regimens (P =0.036).Univariate analysis showed that stage Ⅲ/Ⅳ,IPI score of 3-5,expression of Ki-67 higher than 30％,elevated LDH,elevated β2-MG,blastic variant,more than 5 lymph nodes involved,and failure to chemotherapy were the negative factors.Multivariate analysis showed that Ki-67 index,LDH and the response to chemotherapy were independent factors affecting survival.Conclusions Most patients with MCL were elderly males with advanced stage and usually had bone marrow involvement.Although ORR of CHOP regimen is superior to intense regimens,the prognosis of MCL remains poor.
