73例外周T细胞淋巴瘤患者临床特征及预后分析

目的:对外周T细胞淋巴瘤的临床特征、治疗和预后情况进行分析,探讨该病预后的因素.方法:回顾性分析外周T细胞淋巴瘤的73例患者的临床资料.确诊时中位年龄为42岁,男55例,女18例.治疗前病程中位数3月,接受化、放疗综合治疗5例,单纯化疗65例.自体移植3例.结果:3年及5年生存率分别为38%和22%;,随着Ann Arbor分期增高,生存率明显下降;有B症状(发热、消瘦、盗汗)或国际预后指数(international prognostic factors index,IPI)评分≥2者,其生存率分别显著低于无全身症状者或IPI评分＜2者.血清糖类抗原125(CAl25)或D-二聚体(D-dimer)升高者对化疗反应较差.结论:外周T细胞淋巴瘤是一类侵袭性强、预后不良的疾病.其临床特征、Ann Arbor分期、IPI及B症状是影响预后的重要因素.CA125和D-dimer也对预后有影响.

Clinical characteristics and prognostic factors in 73 patients with peripheral T cell lymphoma

OBJECTIVE: To investigate the clinical features,therapy and prognosis of patients with peripheral T cell lymphoma(PTCL), and to find out the prognostic factors of the disease. METHODS: The clinical data of 73 patients with PTCL were reviewed.The median pre-treatment disease course was 3 months.Fifty-five patients were males, and 18 were females, with the median age of 42 years.Five patients received the combined chemo-radio therapy, 65 received chemotherapy alone, and the other 3 patients were treated with auto hematopoietic stem cell transplantation (HSCT). RESULTS: Of all the patients, the overall 3 -year and 5-year survival rates were 38% (28 /73) and 22% ( 16 /73) respectively.The survival rates decreased with the progression of the Ann Arbor stages.The survival rate of the patients with B symptom (fever, night sweat, and weight loss) or the international prognostic factors index ( IPI)>2 was lower than those of the patients without B symptom or IPI<2.The patients with the increased CA125 or D-dimer lever had the worst curative effect. CONCLUSION: Peripheral T cell lymphoma is highly aggressive with poor prognosis.The clinical features,Ann Arbor staging, IPI and B symptom are important prognostic factors.CA125 and D-dimer may be also important prognostic factors.