血管免疫母细胞型T细胞淋巴瘤的临床特点及预后分析

目的 探讨血管免疫母细胞型T细胞淋巴瘤(AITL)的临床特点及预后影响因素.方法 收集18例有完整治疗及随访记录的AITL患者的临床和随访资料,总结其临床特征,并进行生存分析.患者初治时均接受标准的CHOP样方案治疗,4例曾进行放疗,1例接受了巩固性的大剂量化疗联合自体造血干细胞移植.对6例患者外周血中的T细胞、B细胞和自然杀伤(NK)细胞亚群进行了流式细胞检测.结果 18例患者中位年龄为55岁,男女比例2.6:1.Ⅲ～Ⅳ期和有B症状者占72.2%,贫血者占47.1%,69.2%的患者免疫球蛋白增高,60.0%的患者乳酸脱氢酶(LDH)增高.初治完全缓解(CR)8例,疾病进展(PD)10例,CR率为44.4%.2例多程化疗后的患者,应用沙利度胺治疗,1例获得部分缓解(PR),1例CR,无疾病进展生存时间分别为2个月和6+个月.2年总生存率和2年无病生存率分别为62.2%和44.4%.单因素分析结果 显示,发病年龄和原发耐药情况与生存期有关,发病年龄≥30岁、Ann Arbor分期晚、有B症状和脾肿大与无病生存期缩短有关.4例患者在治疗中出现重症肺炎,其中2例死于呼吸衰竭.6例进行了外周血淋巴细胞比例的流式细胞检测的患者中,5例CD3+ CD4+ T细胞、自然杀伤细胞和B细胞比例降低,而CD3+ CD8+ T细胞比例升高.结论 AITL患者存在天然免疫和获得性免疫功能的下降,一线应用CHOP样方案治疗的疗效欠佳,沙利度胺用于AITL的治疗值得深入研究,年龄<30岁和初治敏感的AITL患者预后较好.     

血管免疫母细胞型T细胞淋巴瘤的临床特点及预后分析

目的 探讨血管免疫母细胞型T细胞淋巴瘤(AITL)的临床特点及预后影响因素.方法 收集18例有完整治疗及随访记录的AITL患者的临床和随访资料,总结其临床特征,并进行生存分析.患者初治时均接受标准的CHOP样方案治疗,4例曾进行放疗,1例接受了巩固性的大剂量化疗联合自体造血干细胞移植.对6例患者外周血中的T细胞、B细胞和自然杀伤(NK)细胞亚群进行了流式细胞检测.结果 18例患者中位年龄为55岁,男女比例2.6:1.Ⅲ～Ⅳ期和有B症状者占72.2%,贫血者占47.1%,69.2%的患者免疫球蛋白增高,60.0%的患者乳酸脱氢酶(LDH)增高.初治完全缓解(CR)8例,疾病进展(PD)10例,CR率为44.4%.2例多程化疗后的患者,应用沙利度胺治疗,1例获得部分缓解(PR),1例CR,无疾病进展生存时间分别为2个月和6+个月.2年总生存率和2年无病生存率分别为62.2%和44.4%.单因素分析结果 显示,发病年龄和原发耐药情况与生存期有关,发病年龄≥30岁、Ann Arbor分期晚、有B症状和脾肿大与无病生存期缩短有关.4例患者在治疗中出现重症肺炎,其中2例死于呼吸衰竭.6例进行了外周血淋巴细胞比例的流式细胞检测的患者中,5例CD3+ CD4+ T细胞、自然杀伤细胞和B细胞比例降低,而CD3+ CD8+ T细胞比例升高.结论 AITL患者存在天然免疫和获得性免疫功能的下降,一线应用CHOP样方案治疗的疗效欠佳,沙利度胺用于AITL的治疗值得深入研究,年龄<30岁和初治敏感的AITL患者预后较好.     

NK细胞比例增高的初治肝癌患者群体存在价值分析

目的 探讨NK细胞比例增高的初治肝癌患者群体存在的意义.方法 采用流式细胞术分析初次治疗的45例肝癌患者NK细胞和CD4+T/CD8+T的比例.结果 45例中38例NK细胞比例(5.72%)和CD4+T/CD8+T的比例(0.60)显著低于正常人水平(13.18%和0.70),7例NK细胞比例(28.78%)和CD4+...     

15例血管免疫母T细胞性淋巴瘤临床病理分析

目的：探讨血管免疫母T细胞性淋巴瘤（angioimmunoblastic T-cell lymphoma，AITL）的病理、临床特点和CHOP方案的近期疗效。方法：同时采用常规组织病理学、免疫组织化学、细胞遗传学对15例淋巴瘤患者淋巴结的手术活检标本进行研究，并以CHOP方案作为初始治疗，复发后以MINE＋P方案解救。结果：15例患者均表达T细胞抗原CD45RB、CD3和CD45RO，10例（10／15）表达CD10，10例（10／15）表达CD21，4例（4／14）染色体异常。全组15例均能评价疗效，15例CHOP方案初治有效率100％均有效，（CR7例，PR8例）。复发8例，MINE＋P方案解救有效6例（CR3例，PR3例），有效率75％。毒副反应以粒细胞计数下降和血小板下降为常见，但均可耐受。结论：常规组织学、免疫组化检查、细胞遗传学是确诊AITL的重要手段，CHOP方案初治有效率高，但易复发，MINE＋P方案解救有效率较高，毒副反应可以耐受。     

剂量调整的EPOCH方案治疗初治血管免疫母T细胞淋巴瘤的前瞻性研究

  目的  前瞻性研究剂量调整的EPOCH方案对初治血管免疫母T细胞淋巴瘤（AITL）患者的疗效及不良反应。   方法  选择2008年9月至2012年9月中国军事医学科学院附属307医院确诊的初治AITL患者9例。全组患者均接受剂量调整的EPOCH方案一线化疗。   结果  全组患者发病中位年龄54岁,男:女为2:1,88.9%为Ann-Arbor stage Ⅲ~Ⅳ期,77.8%合并B症状。初诊时伴有贫血的患者占66.7%,LDH或β2微球蛋白升高占55.6%。EPOCH方案近期疗效CR率22.2%,总反应率66.7%。中位随访20个月,4年PFS和OS分别为11.1%和33.3%,中位生存时间19个月。EPOCH方案化疗主要不良反应为血液学毒性,3~4度粒细胞减少和血小板减少分别为77.8%和33.3%,44.4%的患者出现粒细胞缺乏伴发热。   结论  剂量调整的EPOCH方案一线治疗AITL患者较传统CHOP方案未见明显生存获益。主要不良反应为血液学毒性,并可以耐受。      

血管免疫母细胞性T细胞淋巴瘤临床特点及疗效分析

回顾性分析本院单中心近年收治的血管免疫母细胞性T细胞淋巴瘤（AITL）的临床特点及常规化疗近期疗效。方法:1999年9月～2010年9月于本院明确诊断AITL患者23例,其中21例接受治疗。初次治疗17例予CHOP样或CHOP方案,4例予左旋门冬酰胺酶＋博莱霉素＋地塞米松＋长春地辛方案;化疗后予受累野照射每组各1例,予自体造血干细胞移植巩固治疗每组各1例。复发后予ICE、DHAP或ProMACE/CytaBOM方案化疗。维持治疗采用干扰素或联合沙利度胺治疗者5例,采用西达苯胺者3例。结果:发病中位年龄60岁,男 :女为1.9:1,Ann Arbor Ⅲ～Ⅳ期占96%,57%患者有B组症状,22%患者合并脾受侵/脾肿大。实验室检查结果示,39%患者乳酸脱氢酶升高,75%患者β2微球蛋白升高,80%患者D-二聚体升高。病理组织免疫组化结果显示,CXCL13阳性率100%（12/12）,EBER阳性率80%（8/10）。疗效结果分析,CHOP样方案组7例获CR,8例获PR;含左旋门冬酰胺酶方案组1例获CR,1例获PR。21例患者中位生存27（2.9～51.1）个月,3年、5年总生存率分别为44%、29%。化疗后90％患者出现Ⅲ～Ⅳ度骨髓抑制,33％患者出现肺部感染,1例患者发生带状疱疹。结论:AITL为具有独特临床病理和生物学行为的外周T细胞肿瘤,多数患者同时存在凝血机制异常。AITL患者因并发免疫功能异常,化疗后骨髓抑制及感染问题不容忽视。      

多发性骨髓瘤患者外周血CD4+ CD25+ CD127low调节性T细胞数量及凋亡相关蛋白水平

  目的  探讨外周血CD4+CD25+CD127low调节性T细胞（regulatory T cells,Tregs）在多发性骨髓瘤（multiple myeloma,MM）治疗中的作用。  方法  采用流式细胞术检测30例初治、27例完全缓解（CR）MM患者以及25例健康成年人外周血CD4+ T细胞、Tregs数量,并检测Tregs表面功能分子CTLA-4及其凋亡相关蛋白CD95、bcl-2、Caspase3的表达,分析其与临床特点及疗效的关系。  结果  初治组CD4+ T细胞占外周血单个核细胞的比例低于对照组（P < 0.05）,Ⅲ期初治患者CD4+ T细胞明显低于Ⅰ、Ⅱ期患者（P < 0.05）;初治MM组Tregs占CD4+ T细胞比例显著高于CR组和正常对照组（P < 0.05）,初治Ⅲ期患者Tregs占CD4+ T细胞比例明显高于初治Ⅰ、Ⅱ期患者（P < 0.05）。初治组、CR组和正常对照组Tregs的表面CD95表达无统计学差异（P > 0.05）,初治组CTLA-4表达高于CR组（P < 0.05）和对照组（P < 0.01）,CR患者CTLA-4高于对照组（P < 0.05）,初治组Tregs胞浆内bcl-2水平高于CR组（P < 0.05）和对照组（P < 0.01）,CR组高于对照组（P < 0.05）,初治组和CR组Tregs胞内Caspase3的水平低于对照组（P < 0.05）。初治组Tregs占CD4+比例与骨髓瘤数量呈正相关（P < 0.05）,且Tregs比例与治疗前后浆细胞下降值成反比（r=0.735,P < 0.05）。  结论  MM患者外周血Tregs水平升高,与瘤细胞负荷及疾病的分期呈正相关,与疗效呈负相关;Tregs水平增高与其抗凋亡能力增强有关。      

皮下脂膜炎样T细胞淋巴瘤六例临床及病理特点分析

目的 皮下脂膜炎样T细胞淋巴瘤(subcutaneous pannieulitis-like T cell lymphoma,SPTCL)是一类非常罕见的皮肤T细胞恶性淋巴瘤,相关报道较少且易误诊.本研究旨在分析SPTCL患者的临床及病理特征.方法 回顾性分析2010-01-01-2015-12-31天津医科大学肿瘤医院收治的6例SPTCL患者的临床治疗、预后及病理特征.结果 6例SPTCL患者中,男3例,女3例.6例患者的年龄2～53岁,平均诊断年龄为29岁,其中4例的患者＜30岁.起病部位主要为四肢,5例患者表现为皮下的硬结肿物,1例患者表现为皮肤溃疡和渗出.皮肤损害出现的中位时间为13个月(1～60个月).6例患者中无伴发嗜血细胞综合症(hemophagocytic syndrome,HPS)者.6例患者镜下共同特征是小或中等大小的不典型肿瘤细胞围绕脂肪细胞生长.免疫组化特征为CD3+(100％)、CD4+ (100％)、CD8+(100％)、CD20-(100％)、CD56-(83％)、TCRβF-1+ (100％)、TIA-1+ (100％)、GrB+ (100％)、穿孔素阳性(100％).6例SPTCL患者均接受了以CHOP或CHOP样方案为主的多药联合化疗,化疗后3例患者获得CR,2例患者PR,1例患者SD.CR的3例患者中有2例患者出现复发,其中1例患者经自体造血干细胞移植后获得CR,1例在间断化疗状态下维持SD.获得PR的1例患者经自体造血干细胞移植后获得CR.中位随访时间为47个月(7～73个月),1例失访,3例患者无病生存,2例患者带瘤生存.结论 本研究SPTCL患者呈惰性进展且预后较好,常用的化疗方案为CHOP或CHOP样方案,早期复发或化疗效果欠佳的患者采取自体造血干细胞移植可能获益.     

单纯CHOP样方案与CHOP样方案联合造血干细胞移植巩固治疗淋巴母细胞淋巴瘤的疗效分析

目的 探讨单纯CHOP样方案与CHOP样方案+高剂量治疗联合造血干细胞移植(HDT-HSCT)一线巩固治疗淋巴母细胞淋巴瘤(LBL)的疗效.方法 63例有完整治疗及随访记录的LBL患者,初治均采用标准CHOP样方案,42例获得完全缓解(CR)或不确定CR(CRu).其中26例接受HDT-HSCT巩固治疗,16例单纯进行6～8个周期CHOP样方案治疗.结果 63例患者中,初治总缓解率为82.5%.中位随访24个月时,5年生存率为31.2%,5年无病生存率为29.3%.接受HDT-HSCT巩固治疗的26例患者,5年生存率为59.8%;单纯CHOP样方案治疗的16例患者,5年生存率为14.6%,差异有统计学意义(P=0.004).单因素预后分析结果显示,年龄、骨髓侵犯、初治缓解情况与预后有关(均P<0.05).18例骨髓受侵的患者中,3例接受异基因造血干细胞移植(allo-HSCT)的患者在随访22、32和37个月时仍生存,而4例接受自体造血干细胞移植(auto-HSCT)的患者,均在14个月内死亡.结论 单纯应用CHOP样方案治疗LBL疗效欠佳.HDT-HSCT作为一线巩固治疗有可能提高LBL患者的总生存率和无病生存率.骨髓受侵的LBL患者,allo-HSCT的效果优于auto-HSCT.     

沙利度胺联合CHOP方案治疗侵袭性非霍奇金淋巴瘤临床对照研究

 目的　观察沙利度胺在侵袭性非霍奇金淋巴瘤（NHL）中的治疗作用及不良反应。方法　52例侵袭性恶性淋巴瘤患者,随机分为两组,每组26例。CHOP组：环磷酰胺600 mg／m2静脉注射第1天;表柔比星50 mg／m2,静脉注射第1天;长春新碱1.4 mg／m2,静脉注射第1天,泼尼松50 mg／m2,口服,第1天至第7天。沙利度胺组：化疗方案同CHOP组,加用沙利度胺,200 mg第1天至第14天,口服,第2个疗程剂量增加为400 mg,第1天至第14天。结果　CHOP组CR 7例（26.9 %）,PR 12例（46.2 %）,CR+PR 19例,总有效率为73.1 %;沙利度胺组CR 9例（34.6 %）,PR 14例（53.8 %）,CR+PR 23例,总有效率为88.4 %;两组比较差异无统计学意义（P＝0.25）。沙利度胺组1年生存率（OS）92.6 %,2年OS为83.5 %,CHOP组分别为90.8 %、68.8 %,两组1年OS差异无统计学意义,2年OS差异有统计学意义（P＜0.05）。沙利度胺组外周神经毒性、便秘、疲乏等不良反应发生率高于CHOP组,两组比较差异有统计学意义（P＜0.05）。结论　沙利度胺联合CHOP方案治疗侵袭性NHL,不良反应可以耐受,且在缓解率及生存期方面均优于单纯化疗组。     

Treatment of Peripheral T-Cell Lymphoma in Community Settings

BackgroundPeripheral T-cell lymphomas (PTCLs) represent a rare and heterogeneous group of malignancies that do not have consensus treatment recommendations. Strategies extrapolated from B-cell lymphoma have met with limited efficacy, although T-cell–specific salvage therapies have been recently developed.MethodsTo determine treatment patterns and associated outcomes in PTCL not otherwise specified (PTCL-NOS), anaplastic large T-cell lymphoma (ALCL), and angioimmunoblastic T-cell lymphoma (AITL), a retrospective analysis was undertaken at a large US community oncology network among patients treated between January 2010 and April 2015.ResultsAmong 93 patients (44 PTCL-NOS, 30 ALCL, 19 AITL), 23 unique treatments were used in 66 first-line patients and 12 unique second-line treatments were used in 24 relapsed/refractory patients. First-line CHOP and CHOP-like regimens were used in 74% of patients, providing 4-year overall survival (OS) outcomes of 34% (95% confidence interval [CI], 14%-83%) in patients without transplant consolidation (82% in ALCL, 37% in PTCL-NOS, and 0% in AITL). Upfront stem cell transplantation trended toward improved 4-year progression-free survival 77% (95% CI, 54%-100%) versus 34% (95% CI, 14%-80%); (P = .08; hazard ratio [HR] 0.29) with 4-year OS 77% (95% CI, 54%-100%) versus 34% (P = .22; HR 0.41). Brentuximab was the most common second-line therapy, with multiple additional regimens used in sequence (up to 5 salvage regimens) in many.ConclusionsThe significant variability in treatments used for PTCL emphasizes the lack of consensus therapy in this rarer lymphoma and calls for additional organized prospective and registry studies to evaluate comparative effectiveness.     

CHOP或CHOP样方案一线治疗晚期血管免疫母细胞型T细胞淋巴瘤效果观察

目的 分析CHOP或CHOP样方案一线治疗血管免疫母细胞型T细胞淋巴瘤(AITL)的效果.方法 回顾性分析2006年8月至2014年2月收治的29例应用CHOP或CHOP样方案一线治疗的晚期AITL患者的临床资料,总结其临床特征,分析疗效及其预后因素.结果 患者中位发病年龄为59岁,全部为Ⅲ～Ⅳ期,17例(58.6％)伴B症状,26例(89.7％)IPI评分≥2分,20例(69.0％)起病时乳酸脱氢酶升高,9例(31.0％)出现≥2个结外器官受侵.中位随访20个月,总有效率为69.0％(20/29),其中17.2％(5/29)的患者初治达完全缓解或未确定完全缓解,51.7％(15/29)达部分缓解,20.7％(6/29)出现疾病进展,10.3％(3/29)稳定.中位无进展生存(PFS)期为6个月.1、2年PFS率分别为39.0％、20.0％.1、2、5年总生存(OS)率分别为76.8％、53.4％和17.1％.治疗有效患者PFS长于无效患者(P＜ 0.001),有效与无效患者OS差异无统计学意义(P＞0.05).结论 CHOP或CHOP样方案一线治疗AITL的总体疗效不满意,有待进一步探索新的治疗方法.     

Angioimmunoblastic T-cell lymphoma: the effect of initial treatment and microvascular density in 31 patients

The objectives of this study are to explore the clinical features and treatment outcomes and to investigate the correlation between microvessel density (MVD) and survival in patients with angioimmunoblastic T-cell lymphoma (AITL). We retrospectively analyzed clinical and follow-up data of 31 patients treated in two hospitals during 1995-2009 histologically proven AITL. We also assessed MVD in the lump of 31 previously untreated patients using α-CD34 immunohistochemical staining. The median age of the 31 patients was 48?years, eighty percent of the patients were in an advanced stage. 67.7% of them had B symptoms, with the follow-up of 2-13?years, the 5-year overall survival rate was 25.8%. The response rates (RR) of CHOP group and COP (cyclophosphamide, vincristine and prednisolone) group are 76.5 and 75%, respectively, which is no significant difference (P?=?0.894). RR did not differ whether chemotherapy regimens contained anthracycline or not. The 3-year PFS rate for patients who received COP and CHOP regimen was 25.4 and 35.3% (P?=?0.562), while 5-year OS rates were 25.0 and 29.4%, respectively (P?=?0.667). The median PFS for patients with high MVD and low MVD were 15.1 and 30.0?months (P?=?0.048), while the median OS were 20 and 45?months, respectively (P?=?0.038). Patients who were sensitive to initial chemotherapy COP regimen have the similar therapeutic effect to CHOP regimen. Patients with high MVD measured in the microenvironment had worse PFS and OS than AITL patients with low expression.     

Adjuvant therapy in rectal cancer: analysis of stage, sex, and local control--final report of intergroup 0114.

PURPOSE: The gastrointestinal Intergroup studied postoperative adjuvant chemotherapy and radiation therapy in patients with T3/4 and N+ rectal cancer after potentially curative surgery to try to improve chemotherapy and to determine the risk of systemic and local failure. PATIENTS AND METHODS: All patients had a potentially curative surgical resection and were treated with two cycles of chemotherapy followed by chemoradiation therapy and two additional cycles of chemotherapy. Chemotherapy regimens were bolus fluorouracil (5-FU), 5-FU and leucovorin, 5-FU and levamisole, and 5-FU, leucovorin, and levamisole. Pelvic irradiation was given to a dose of 45 Gy to the whole pelvis and a boost to 50.4 to 54 Gy. RESULTS: One thousand six hundred ninety-five patients were entered and fully assessable, with a median follow-up of 7.4 years. There was no difference in overall survival (OS) or disease-free survival (DFS) by drug regimen. DFS and OS decreased between years 5 and 7 (from 54% to 50% and 64% to 56%, respectively), although recurrence-free rates had only a small decrease. The local recurrence rate was 14% (9% in low-risk [T1 to N2+] and 18% in high-risk patients [T3N+, T4N]). Overall, 7-year survival rates were 70% and 45% for the low-risk and high-risk groups, respectively. Males had a poorer overall survival rate than females. CONCLUSION: There is no advantage to leucovorin- or levamisole-containing regimens over bolus 5-FU alone in the adjuvant treatment of rectal cancer when combined with irradiation. Local and distant recurrence rates are still high, especially in T3N+ and T4 patients, even with full adjuvant chemoradiation therapy.     

Cyclosporine, prednisone, and high-dose immunoglobulin treatment of angioimmunoblastic T-cell lymphoma refractory to prior CHOP or CHOP-like regimen

Angioimmunoblastic T-cell lymphoma (AITL) is a rare, distinct subtype of peripheral T-cell lymphoma, possessing an aggressive course and poor prognosis with no standard therapy. Twelve patients who have failed at least two initial CHOP or CHOP-like regimens were enrolled in this study and treated with individualized cyclosporine (CsA), prednisone (PDN), and monthly, high-dose intravenous immunoglobulin (HDIVIG). The dose of CsA was adjusted individually based on the blood trough concentration of CsA and renal function. All patients were examined for response, toxicity and survival. The most significant toxicities (≥ grade 2) were infection (16.7%), renal insufficiency (8.3%), hypertension (8.3%), diabetes (8.3%) and insomnia (16.7%). Discontinuation of treatment occurred in one patient (8.3%) due to grade 3 renal toxicity and subsequent grade 4 pulmonary infection. Treatment-related death was not observed. The overall response rate was 75.0% (complete response, 33.3%; partial response, 41.7%). With a median follow-up of 25.5 months, the median duration of response was 20 months (range, 12 to 49 months) and the median progression-free survival (PFS) was 25.5 months (range, 10 to 56 months). The 2-year PFS rate was 81.5%. Our findings indicate the combination of CsA, PDN and HDIVIG is an effective salvage regimen for refractory or relapsed AITL with predictable and manageable toxicity.     

Clinical features and treatment outcomes of angioimmunoblastic T-cell lymphoma

The objective of this retrospective study was to investigate clinical features and treatment outcomes in patients with angioimmunoblastic T-cell lymphoma (AITL), data of which were collected over a 15-year period. Sixty-five patients diagnosed with AITL were included in the study. About half of the patients (46.2%) presented with poor performance status (ECOG > or = 2); 72.3% of patients belonged to high intermediate or high-risk of IPI and same proportion belonged to Class 2 of PIT (Prognostic index for PTCL-U), and most patients (95.4%) were diagnosed at an advanced stage. At diagnosis, 27 patients (41.5%) presented with malignant pleural effusion, and 22 patients (33.8%) had skin involvement. Most of the initial chemotherapy regimens were anthracycline-based (88.2%). Overall response rate to initial chemotherapy was 86.2% (64.7% of complete response, 21.5% of partial response). The median progression-free survival and overall survival of all patients was 7.1 months (95% CI, 2.8 - 11.4) and 15.1 months (95% CI, 6.7 - 23.5), respectively. Age, performance status, and PIT scores were predictive prognostic factors for survival. In conclusion, although AITLs showed a good response to the initial chemotherapy, their response durations were short; therefore, chemotherapy for AITL should be modified or intensified as in high-dose chemotherapy.     

多西他赛对复发转移性乳腺癌免疫功能的影响

目的：探讨多西他赛化疗前、化疗2周期评价疗效时复发转移性乳腺癌（MBC）患者外周血淋巴细胞亚群比率的变化及影响因素。方法应用流式细胞仪检测34例行多西他赛一线化疗的复发MBC患者化疗前、化疗2周期评价疗效时外周血淋巴细胞亚群[CD3+T淋巴细胞、CD3+/CD4+T淋巴细胞、CD3+/CD8+T淋巴细胞、CD3－/CD16+56+自然杀伤细胞（NK）、CD3+/CD16+56+T淋巴细胞、CD19+B淋巴细胞、CD4+/CD25+调节性T细胞（Treg细胞）、CD8+/CD28－T淋巴细胞和CD8+/CD28+T淋巴细胞]比率,并进一步分析患者临床病理因素对于外周血淋巴细胞亚群变化的影响。结果34例患者化疗后CD3+总T淋巴细胞、CD3+/CD4+T淋巴细胞及CD19+B淋巴细胞比率均较化疗前下降（P=0.002、0.044、0.006）,下降平均比率分别为2.2%、4.7%、3.1%。中位年龄﹥54岁的患者CD19+B淋巴细胞下降比率较中位年龄≤54岁的患者小（P=0.031）;中位OS﹥3.6个月的患者CD3+总T淋巴细胞下降比率较中位OS≤33.6个月的患者小（P=0.038）。结论多西他赛化疗后MBC患者外周血总T、B淋巴细胞比率下降,免疫功能降低,而相对保留较好的T淋巴细胞免疫功能的患者可能有更好的生存获益。