介于弥漫大B 细胞淋巴瘤和伯基特淋巴瘤之间的未分类淋巴瘤

Clinical analysis of unclassifiable B-cell lymphoma intermediates between diffuse lage B-cell lymphoma and Burkitt lymphoma

  • 摘要: 目的:分析介于弥漫大B 细胞淋巴瘤和伯基特淋巴瘤之间的未分类的B 细胞淋巴瘤(B-cell lymphoma ,unclassifiable,with features intermediate between DLBCL and Burkitt lymphoma,DLBCL/BL)的临床特点、治疗与预后,增加对该病的认识。方法:收集郑州大学第一附属医院2013年1 月至2014年12月收治的13例DLBCL/BL患者临床病理资料,采用Kaplan-Meier 法进行生存分析,采用Logrank 检验对临床分期、年龄、LDH 水平、IPI 评分、初治化疗方案等进行单因素分析。结果:13例患者中12例存在结外侵犯,13例患者的中位OS为10个月,中位PFS 为6 个月。单因素分析显示IPI 评分、LDH 水平与预后有统计学相关性,行CHOP、CHOP 样与高强度化疗方案患者之间生存差异具有统计学意义(P = 0.054)。 结论:DLBCL/BL恶性程度高,生存期短,结外侵犯多见,对CHOP 及CHOP 样方案治疗反应差,高强度化疗可能改善预后,IPI 评分≥ 3 分及 LDH 升高是其不良预后因素。

     

    Abstract: Objective:To analyze clinical characteristics, treatment, and prognosis of B-cell lymphoma, unclassifiable, with features in -termediate between diffuse large B-cell lymphoma and Burkitt lymphoma (DLBCL/BL). Methods:The clinical and pathological data of 13DLBCL/BL patients, who were treated in the First Affiliated Hospital of Zhengzhou University between January 2013and December 2014, were collected. Overall survival (OS) and progression-free survival (PFS) were estimated by the Kaplan-Meier method. Through the log-rank test, survival curves were compared among groups classified by clinical stage, age, serum lactate dehydrogenase (LDH) lev -el, international prognostic index (IPI) score, or first chemotherapy regimen. Results: Among the 13patients with DLBCL/BL, 12pa-tients showed extra nodal involvement. The median OS and PFS were only 10and 6 months, respectively. Univariate analysis showed that the LDH levels and IPI scores exerted statistically significant effects on prognosis. Some borderline differences in survival were not -ed among the CHOP, CHOP- like, and intensive chemotherapy groups. Conclusion: DLBCL/BL is an aggressive B- cell lymphoma with a short survival time. The majority of patients presented extra-nodal involvement. DLBCL/BL did not respond well to CHOP or CHOP-like regimen, and more intensive chemotherapy may improve survival. Elevated LDH levels and high IPI scores were predictors of poor sur -vival.

     

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