摘要
目的：探讨结性外周T细胞淋巴瘤（PTCL）的疗效和预后因素。方法：回顾分析1998年5月～2008年2月期间收治的56例结性PTCL，比较不同治疗方法的疗效，探讨预后因素。结果：外周T细胞淋巴瘤非特指型（PT—CL—U）37例（66．1％），系统性间变大细胞淋巴瘤（ALCL）12例（21．4％），血管免疫母细胞淋巴瘤（AITL）7例（12．5％）。CHOP化疗组25例（51．0％），强化治疗组12例（24．5％），自体造血干细胞移植（ASCT）12例（24．5％）。完全缓解（CR）率为71．4％，中位随访11．9个月，3年总生存率为20．0％。化疗组和ASCT组3年总生存率分别为15．8％和38．2％（P=0．038）。预后不良因素包括一般状况差（ECOG≥2分）、结外受累≥2个部位、乳酸脱氢酶升高、血小板〈150x10。／L、骨髓侵犯、AnnArbor分期Ⅳ期、国际预后指数（IPI）≥3个危险因素以及未获得CR。多因素分析发现是否获得CR（RR，9．924；95％CI，2．412～40．832；P〈0．001）是唯一独立预后因素。结论：结性PTCL化疗反应率较高，但远期疗效很差；取得CR后进行ASCT可以提高结性PTCL的疗效。
Objective： To identify significant prognostic factors of nodal peripheral T-cell lymphoma and to compare the outcomes of different therapeutic regimens. Methods： A total of 56 cases of nodal peripheral T-cell lymphoma fulfilling the criteria defined by the World Health Organization classification were retrospectively analyzed. Results： There were 37 cases of peripheral T-cell lymphoma unspecified （PTCL-U）, 12 cases of primary systemic type anaplastic large-cell lymphoma （ALCL）, and 7 cases of angioimmunoblastic T-cell lymphoma （AITL）. The median age of patients was 38.5 years （range： 6-77 years）, and the male-to-female ratio was 2.7：1. Twenty-five cases received CHOP therapy, 12 cases received intensive treatments, and 12 cases received autologous stem cell transplantation （ASCT）. Complete remission was achieved in 71.4% of the patients and the 3-year overall survival rate was 20.0%. Factors associated with a poorer overall survival in a univariate analysis were performance status （ECOG） equal to or greater than 2, equal to or greater than 2 extranodal sites, lactate dehydrogenase level higher than normal, platelets less than 150,000, bone marrow involvement, Ann Arbor Stage IV, equal to or greater than 3 risk factors in the International Prognostic Index （IPI）, and not achieving complete remission. Histological subtype was not correlated to patient survival. Multivariate analysis showed complete remission （RR, 9.924; 95% CI, 2.412 -40.832; P〈0.001） was the only factor independently predictive for survival. Conclusion： The response rate of nodal PTCL is not low, but patient survival is poor. ASCT can improve the outcome for patients with nodal peripheral T-cell lymphoma.
出处
《中国肿瘤临床》
CAS
CSCD
北大核心
2009年第20期1141-1144,共4页
Chinese Journal of Clinical Oncology
基金
卫生部临床科学重点项目基金
天津市社会发展计划项目基金资助(编号:05YFSZSY02400)~~
