中华老年多器官疾病杂志
中華老年多器官疾病雜誌
중화노년다기관질병잡지
Chinese Journal of Multiple Organ Diseases in the Elderly
2015年
11期
817-821
,共5页
郝杰%赵明哲%刘占云%刘振宇%李良群%张本田%郭琼%陈瑜%赵维莅%王黎
郝傑%趙明哲%劉佔雲%劉振宇%李良群%張本田%郭瓊%陳瑜%趙維蒞%王黎
학걸%조명철%류점운%류진우%리량군%장본전%곽경%진유%조유리%왕려
非霍奇金淋巴瘤相关性噬血细胞综合征%治疗%预后
非霍奇金淋巴瘤相關性噬血細胞綜閤徵%治療%預後
비곽기금림파류상관성서혈세포종합정%치료%예후
non-Hodgkin’s lymphoma-associated hemophagocytic syndrome%treatment%prognosis
目的:探讨非霍奇金淋巴瘤相关性噬血细胞综合征(LAHS)的临床特点、治疗和预后。方法回顾性分析2005年1月至2013年12月上海交通大学附属瑞金医院血液科收治的32例LAHS患者的临床资料。用Kaplan-Meier法分析患者的总生存时间,应用Cox相关模型对可能影响生存的14项因素进行回归分析。结果32例患者中,国际预后指数(IPI)评分高危(4~5分)有7例(22%)。淋巴瘤病理分型以T细胞或自然杀伤细胞(NK)/T细胞型为主。32例患者中,有23例接受了含有依托泊苷的化疗方案,其中完全缓解(CR)8例(35%),部分缓解(PR)6例(26%),总有效率(ORR)达61%。有9例患者未接受联合依托泊苷的化疗方案,CR仅1例(11%),无患者达PR,两组比较,疗效有统计学差异(χ2=4.874,P=0.036)。本研究中,32例非霍奇金LAHS的患者中位生存时间为122d(95%CI:79.0~165.0),多因素分析结果显示未达CR(P=0.001)和纤维蛋白原(Fg)低于正常(<1.5g/L, P=0.031)是影响患者总生存率的相关预后因素。结论 LAHS常伴有多个脏器受损的表现,病情进展迅速,预后差。含有依托泊苷的化疗方案,有助于改善患者的治疗效果。
目的:探討非霍奇金淋巴瘤相關性噬血細胞綜閤徵(LAHS)的臨床特點、治療和預後。方法迴顧性分析2005年1月至2013年12月上海交通大學附屬瑞金醫院血液科收治的32例LAHS患者的臨床資料。用Kaplan-Meier法分析患者的總生存時間,應用Cox相關模型對可能影響生存的14項因素進行迴歸分析。結果32例患者中,國際預後指數(IPI)評分高危(4~5分)有7例(22%)。淋巴瘤病理分型以T細胞或自然殺傷細胞(NK)/T細胞型為主。32例患者中,有23例接受瞭含有依託泊苷的化療方案,其中完全緩解(CR)8例(35%),部分緩解(PR)6例(26%),總有效率(ORR)達61%。有9例患者未接受聯閤依託泊苷的化療方案,CR僅1例(11%),無患者達PR,兩組比較,療效有統計學差異(χ2=4.874,P=0.036)。本研究中,32例非霍奇金LAHS的患者中位生存時間為122d(95%CI:79.0~165.0),多因素分析結果顯示未達CR(P=0.001)和纖維蛋白原(Fg)低于正常(<1.5g/L, P=0.031)是影響患者總生存率的相關預後因素。結論 LAHS常伴有多箇髒器受損的錶現,病情進展迅速,預後差。含有依託泊苷的化療方案,有助于改善患者的治療效果。
목적:탐토비곽기금림파류상관성서혈세포종합정(LAHS)적림상특점、치료화예후。방법회고성분석2005년1월지2013년12월상해교통대학부속서금의원혈액과수치적32례LAHS환자적림상자료。용Kaplan-Meier법분석환자적총생존시간,응용Cox상관모형대가능영향생존적14항인소진행회귀분석。결과32례환자중,국제예후지수(IPI)평분고위(4~5분)유7례(22%)。림파류병리분형이T세포혹자연살상세포(NK)/T세포형위주。32례환자중,유23례접수료함유의탁박감적화료방안,기중완전완해(CR)8례(35%),부분완해(PR)6례(26%),총유효솔(ORR)체61%。유9례환자미접수연합의탁박감적화료방안,CR부1례(11%),무환자체PR,량조비교,료효유통계학차이(χ2=4.874,P=0.036)。본연구중,32례비곽기금LAHS적환자중위생존시간위122d(95%CI:79.0~165.0),다인소분석결과현시미체CR(P=0.001)화섬유단백원(Fg)저우정상(<1.5g/L, P=0.031)시영향환자총생존솔적상관예후인소。결론 LAHS상반유다개장기수손적표현,병정진전신속,예후차。함유의탁박감적화료방안,유조우개선환자적치료효과。
ObjectiveTo investigate the clinical features, treatmentefficiency and prognosis of non-Hodgkin’s lymphoma-associated hemophagocytic syndrome (LAHS).MethodsClinical data of 32 LAHS patients treated intheDepartment ofHematologyinRuijin Hospitalfrom January 2005 to December 2013were retrospectively collected. Kaplan-Meiersurvival analysiswas used to estimate survival functions. Cox regression modelwasperformedto evaluate 14 factors affectingsurvival. Results Among the 32 patients, 7(22%)were of high risk(4-5 points)according to the international prognostic index (IPI). T-cell or natural killer (NK)/T cell subtypes were the most predominantpathologicalsubtypes. Of the 23 patients who were treated with the regimenscontainingetoposide, 8 patients (35%) achieved complete remission (CR) and 6 patients (26%) partial remission (PR), withanoverall response rate (ORR)of 61%. Of the 9 patients who were treated with the regimens without etoposide, only 1 patient (11%) achieved CR and none PR (0%). The regimens with etoposide were moreefficient than those without etoposide (Chi square=4.874,P=0.036). The median overall survival (OS) of the cohort was 122 days (95%CI=79.0165.0). Multivariate analysis showed that CRnon-achievement(P=0.001)and subnormal hypofibrinogenemia (<1.5g/L,P=0.031) were the predictive parameters for total survival rate.ConclusionLAHS is usuallyaccompanied with multi-organ dysfunctions, and has rapid progression and poor prognosis. Regimens containing etoposide significantly improve the treatment outcome of those patients.