新疆地区外周T细胞淋巴瘤非特指型52例临床特征及预后分析

目的探讨新疆地区汉族、维吾尔族外周T细胞淋巴瘤非特指型(peripheral T-cell lymphoma,nototherwise specified,PTCL-NOS)的临床特征及其预后因素。方法回顾性分析新疆医科大学附属肿瘤医院2002年1月-2011年6月收治的52例PTCL-NOS患者的临床资料,汉族39例,维吾尔族13例;男性38例,女性14例;确诊时中位年龄35.5岁(8～75岁)。单纯化疗35例,放、化疗综合治疗11例,大剂量化疗联合自体外周血干细胞移植化疗6例。采用Kaplan-Meier法进行生存分析,Cox比例风险模型分析影响预后的因素。结果全组患者中位生存期为30个月(95%CI:19.2～40.8个月),3年生存率与5年生存率分别为39%与32%。单因素分析显示,Ann Arbor分期、结外病变、体力状态(performance status,PS)评分、骨髓受侵、乳酸脱氢酶(lactate dehy-drogenase,LDH)水平及治疗方式与PTCL-NOS患者的预后相关(P<0.05)。多因素分析显示,LDH水平、骨髓侵犯及PS评分是PTCL-NOS患者的独立预后因素。结论新疆地区汉族、维吾尔族PTCL-NOS总体生存率较低,其治疗模式仍需进一步探讨。

Clinical characteristics and prognosis of 52 patients with peripheral T-cell lymphoma non-specified in Xinjiang region

Objective To investigate the clinical characteristics and prognostic factors of patients with peripheral T-cell lymphoma,not otherwise specified(PTCL-NOS).Methods Records of 52 patients with PTCL-NOS treated from January 2002 to June 2011 in Affiliated Tumor Hospital of Xinjiang Medical University were retrospectively analyzed.All the patients were classified according to WHO(2008) classification criteria.Median age of the whole group was 35.5 years(8～75 years old).Of the 52 patients,38 caese were men,and 14 cases were women.67.3% of the patients were treated with chemotherapy alone while 21.2% with chemotherapy plus involved field radiotherapy,and 11.5% of the patients received autologous peripheral blood stem cell transplantation(APBSCT).Kaplan-Meier method was used for survival analysis and Cox regression model for multivariate analysis.Results With a median follow-up duration of 24.5 months,the median overall survival time was 30 months(95% CI: 19.9～40.8 months).The 3 and 5 year overall survival(OS) rates were 39% and 32%.In univariate analysis,clinical stage,performance status(PS),l-lactate dehydrogenase(LDH) involved bone marrow and treatment methods were statistically significantly correlated to the prognosis.In multivariate analysis,elevated LDH level,involved bone marrow and PS≥2 were statistically significant unfavorable prognostic factors.Conclusion The long-term survival of patients with PTCL-NOS in Xinjiang region was poor.Its mode of treatment still need to be further explored.