临床肿瘤学杂志

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39例血管免疫母细胞性T细胞淋巴瘤的临床特点和预后分析

黄晓路,顾康生   

  1. 安徽医科大学第一附属医院肿瘤内科
  • 收稿日期:2016-08-21 修回日期:2016-11-08 出版日期:2017-03-31 发布日期:2018-06-06
  • 通讯作者: 顾康生

Clinical characteristics and prognosis of 39 patients with angioimmunoblastic T-cell lymphoma

HUNAG Xiaolu, GU Kangsheng.   

  1. Department of Medical Oncology,the First Affiliated Hospital of Anhui Medical University
  • Received:2016-08-21 Revised:2016-11-08 Online:2017-03-31 Published:2018-06-06
  • Contact: GU Kangsheng

摘要: 目的探讨血管免疫母细胞性T细胞淋巴瘤(AITL)的临床特征和预后因素。方法 回顾性分析安徽医科大学第一附属医院2009年2月至2016年6月收治的39例 AITL患者的临床资料。39例AITL患者治疗均采用全身化疗,其中29例行标准CHOP方案,化疗2个周期后评价客观疗效。采用 Kaplan-Meier方法进行生存分析,各亚组间的比较采用Log-rank检验。结果 39例患者中位发病年龄为62岁,男女比例为2.5∶1,Ann Arbor分期Ⅲ~Ⅳ期者30例,ECOG评分>1者13例,乳酸脱氢酶(LDH)升高者29例,β2微球蛋白(β2MG)升高者20例,低白蛋白水平者19例,淋巴细胞数增多者19例,结外侵犯数目>1者12例,有浆膜腔积液者16例,Ki67≥50% 者11例,IPI评分2~5 者33例。全组患者获完全缓解(CR)9例,部分缓解(PR)14例,有效率(RR)为58.9%。全组患者预期1、2、3 年生存率分别为81%、59%、40%,中位OS为27个月(95%CI:15.139~38.861个月),中位PFS为9个月(95%CI:1.317~16.683个月)。单因素分析显示,ECOG评分>1、结外侵犯数目>1、有浆膜腔积液、Ki-67≥50%与AITL患者的不良预后相关。结论 AITL是一种侵袭性强、预后不良的疾病。患者治疗前ECOG评分、结外侵犯数目、是否存在浆膜腔积液和Ki-67水平可作为其预后的参考因素。

Abstract: Objective To investigate the clinical characteristics and prognostic factors of patients with angioimmunoblastic T-cell lymphoma (AITL). Methods The clinical data of 39 patients with AITL admitted to the First Affiliated Hospital of Anhui Medical University from February 2009 to June 2016 were collected. All patients were treated by combined chemotherapy, and 29 of them received standard CHOPbased treatment. The response to chemotherapy was assessed after 2 cycles. Factors associated with overall survival were analyzed univariately by KaplanMeier method and Log-rank test. Results The median age was 62 years old for 39 patiens, and the maletofemale was 2.5∶1. Ann Arbor staging showed that 30 cases were stage Ⅲ-Ⅳ. The ECOG score>1 was found in 13 cases, 29 cases had elevated lactic dehydrogenase(LDH), 20 cases had increased Beta 2-microglobulin(β2-MG).The low level of albumin was found in 19 cases,19 cases had increased lymphocyte,12 cases had>1 extranodal involvement, 16 cases had serous cavity effusion, Ki-67≥50% was found in 11 cases, 33 cases had an international prognostic index (IPI) score≥2. Of the 39 cases, 9 cases had complete response and 14 cases had partial response. The overall response rate was 58.9%. The expected 1-,2- and 3-year overall survival rate was 81%, 59% and 40%, respectively. The median overall survival was 27 months(95%CI:15.139-38.861)and the median progressionfree survival was 9 months(95%CI:1.317-16.683). Univariate analysis showed that ECOG score>1, extranodal involvement>1 site, serous cavity effusion and Ki-67≥50% were adverse prognostic factors of AITL(P<0.05). Conclusion AITL is highly aggressive with poor prognosis. ECOG, extranodal involvement, serous cavity effusion and Ki-67 may be prognostic factors of AITL.

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