平凌燕, 郑文, 王小沛, 谢彦, 林宁晶, 涂梅峰, 应志涛, 刘卫平, 张晨, 邓丽娟, 宋玉琴, 朱军. 98例套细胞淋巴瘤临床特点及预后分析[J]. 中国肿瘤临床, 2014, 41(19): 1234-1238. DOI: 10.3969/j.issn.1000-8179.20141455
引用本文: 平凌燕, 郑文, 王小沛, 谢彦, 林宁晶, 涂梅峰, 应志涛, 刘卫平, 张晨, 邓丽娟, 宋玉琴, 朱军. 98例套细胞淋巴瘤临床特点及预后分析[J]. 中国肿瘤临床, 2014, 41(19): 1234-1238. DOI: 10.3969/j.issn.1000-8179.20141455
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PING Lingyan, ZHENG Wen, WANG Xiaopei, XIE Yan, LING Ningjing, TU Meifeng, YING Zhitao, LIU Weiping, ZHANG Chen, DENG Lijuan, SONG Yuqin, ZHU Jun. Analysis of clinical features and prognosis of 98 patients with mantle cell lymphoma[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2014, 41(19): 1234-1238. DOI: 10.3969/j.issn.1000-8179.20141455
Citation: PING Lingyan, ZHENG Wen, WANG Xiaopei, XIE Yan, LING Ningjing, TU Meifeng, YING Zhitao, LIU Weiping, ZHANG Chen, DENG Lijuan, SONG Yuqin, ZHU Jun. Analysis of clinical features and prognosis of 98 patients with mantle cell lymphoma[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2014, 41(19): 1234-1238. DOI: 10.3969/j.issn.1000-8179.20141455
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98例套细胞淋巴瘤临床特点及预后分析

Analysis of clinical features and prognosis of 98 patients with mantle cell lymphoma

    摘要
  • 摘要:
      目的  探讨套细胞淋巴瘤（mantle cell lymphoma，MCL）患者的临床特点、不同治疗方案的疗效及预后分析。
      方法  回顾性分析2005年1月至2013年12月北京大学肿瘤医院收治的98例MCL患者资料，结合临床特征和治疗方案进行相关预后分析。
      结果  98例患者中位发病年龄61岁，男女比例2.9:l，Ann Arbor分期Ⅲ~Ⅳ期患者为85例，占86.8%。骨髓累及者46例（46.9%）。消化道为最常见的结外侵犯器官，共25例患者（25.5%）出现消化道侵犯。53例患者接受R-CHOP方案一线治疗，预期3年生存率为61.4%；14例患者接受自体造血干细胞移植（ASCT）治疗，预期5年生存率为92.3%，其总生存期显著高于使用R-CHOP方案治疗的患者（75.5个月vs. 43.6个月，P=0.039）。年龄>60岁、血沉高于正常、LDH高于正常、B症状、Ki-67≥25%、病理存在母细胞或大B细胞转化均提示预后不佳（P < 0.05）。
      结论  MCL以晚期多见，常伴有骨髓及结外病变，单纯R-CHOP方案不能获得满意疗效，ASCT治疗MCL的疗效好于常规化疗，且安全性较高。年轻患者应该选择作为一线巩固治疗。

     

    Abstract:
      Objective   To study the clinical features, therapeutic effects, survival time, and prognosis of patents with mantle cell lymphoma (MCL).
      Methods   Clinical data of 98 MCL patients admitted from January 2005 to December 2013 were retrospectively analyzed.
      Results   The median age was 61 years old, and the male-to-female ratio was 2.9:1. Among these cases, 85 (86.8%) were in Ann Arbor stage Ⅲ-Ⅳ, 46 (46.9%) had bone marrow involvement, 25 (25.5%) had digestive tract involvement, and 53 chose R-CHOP as first-line treatment. The expected 3-year overall survival (OS) of these patients was only 61.4%. A total of 14 cases were treated with R-CHOP followed by ASCT. The expected 5-year OS was 92.3%, and the OS of the ASCT group was significantly higher than that of the R-CHOP group (75.5 months vs. 43.6 months, P=0.039). Elevated ESR, >60 years old, increased LDH level, B symptoms, and Ki-67≥25% were poor prognostic factors.
      Conclusion   Most patients with MCL were elder adults with bone marrow involvement. R-CHOP followed by ASCT had better clinical efficacy than conventional chemotherapy in the treatment of MCL

     

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