摘要
目的 探讨进展型B细胞淋巴瘤的临床疗效及预后的影响因素。方法 从 1993～ 1997年本中心治疗的进展型非霍奇金淋巴瘤 ,对符合以下条件的患者纳入分析对象 :( 1)病理确诊为弥漫性小裂细胞 (E)、弥漫性混合细胞 (F)、弥漫性大细胞 (G)及弥漫性免疫母细胞 (H)性淋巴瘤 ,且有免疫组织化学证实为B细胞 ;( 2 )CHOP方案或其他含蒽环类化疗方案治疗至少 4个疗程或以上。结果 有 2 0 3例患者纳入统计分析 ,可评价客观疗效的病例 191例 ,其中CR 131例 ( 6 8 9% ) ,PR 47例( 2 4 6 % )。全组患者的 6年总生存率为 5 1 4% ,6年无进展生存期为 43 3%。按照IPI分层 ,发现低危组 6年生存率为 6 6 6 % ,低中危组为 42 2 % ,中高危组为 2 3 6 % ,而高危组为 10 0 % ,差异有显著意义(P =0 0 0 0 0 )。 6年无进展生存期分别为 5 9 7% ,30 2 % ,16 7%和 10 3% (P =0 0 0 0 0 )。生存相关分析发现 ,6年总生存期及 6年无进展生存期与分期、PS状态、结外病变的个数、LDH、巨大肿物 (直径≥ 5cm)、B症状这几个临床指标相关。结论 IPI低危的进展型B细胞淋巴瘤患者以CHOP方案为主的治疗疗效较好 ,而IPI低中危、中高危、高危的患者疗效较差 ,5年生存率低于国外。
Objective To analyze the curative effect of aggressive B cell non-Hodgkin′s lymphoma and relevant influencing factors of its prognosis. Methods The curative effects of aggressive non-Hodgkin′s lymphoma which were diagnosed as diffuse small cleaved (E), diffuse mixed (F), diffuse large cell (G) or diffuse immunoblastic lymphoma (H) pathologically and certified as B cell lymphoma immunohistologically and treated with CHOP or other ADM-containing regimens for at least 4 cycles from 1993 to 1997 were analyzed. An analysis of the correlation of prognosis with different factors was made. Results The curative effects of 191 out of the 230 cases were evaluated. 131(68.9%) patients achieved CR, and 47 (24.6%) achieved PR. The 6-year overall survival (OS) rates and progress free survival (PFS) rates were 51.4% and 43.3% respectively. According to IPI risk stratification, the 6-year OS rates were 66.6%, 42.2%, 23.6%, and 10.0% in the low-risk, low-intermediate-risk, high-intermediate- risk, and high risk groups respectively (P=0.000 0). The 6-year PFS rates were 59.7%, 30.2%, 16.7%, and 10.3% in the low-risk, low intermediate risk, high-intermediate- risk, and high risk groups respectively. The prognosis analysis showed that OS and PFS were significantly correlated with different clinical characteristics such as stage, PS, number of extra-nodal lesions, LDH bulky disease, and B symptom. Conclusion The treatment with CHOP as its main component has a beneficial effect on aggressive B cell lymphoma in low risk group, but is less effective for the low-intermediate, high-intermediate, and high risk.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2003年第3期191-194,共4页
National Medical Journal of China
