共查询到18条相似文献,搜索用时 203 毫秒
1.
目的探讨高危非霍奇金淋巴瘤(NHL)患儿的临床特征与治疗效果。方法对2003—2008年我院收治的24例高危NHL患儿的临床表现、检查、诊断、疾病进展及治疗方案进行分析。2例行自体外周血干细胞移植(APBSCT),1例行血缘相关PBSCT。除2例淋巴母细胞白血病/淋巴瘤予BFM2002高危急性淋巴细胞白血病化疗方案外,余予德国B-NHL-BFM-90方案。结果2例急性髓细胞白血病微分化型(AML.U0)并噬血细胞综合征(HLH)误诊为Ⅳ期淋巴瘤合并HLH。3例患儿均移植成功。前体T细胞淋巴母细胞白血病/淋巴瘤除1例采用BFM2002高危急性T淋巴细胞白血病化疗方案效果尚满意外,余未达CR或复发。余14例中7例完全缓解;4例部分缓解;3例进展。结论结合细胞形态、病理免疫组化、流式细胞学检查,必要时多次活检对诊断高危NHL至为重要。高危NHL患儿仅部分对德国B-NHL-BFM-90方案反应良好,前体T细胞淋巴母细胞白血病/淋巴瘤需进一步探讨急性T淋巴细胞白血病化疗方案的优越性。应用PBSCT是治疗儿童高危NHL的有效方法之一,合适的移植时机和预处理至关重要。 相似文献
2.
小儿非霍奇金淋巴瘤的治疗现状 总被引:1,自引:0,他引:1
卢新天 《国外医学:输血及血液学分册》1996,19(1):1-4
小儿非霍奇金淋巴瘤的治疗以化疗为主,目前趋向于根据不同的病理类型、免疫学类型及病期选择化疗方案,对淋巴母细胞淋巴瘤多主张采用与急性淋巴细胞白血病相似的治疗方案,对小无裂细胞淋巴瘤采用以环磷酰胺和氨甲喋呤等药物组成的方案;而大细胞性淋巴瘤的最佳治疗选择仍在探讨之中。 相似文献
3.
目的:探讨母细胞性浆细胞样树突细胞肿瘤(BPDCN)的临床表现、诊断、治疗方案及预后。方法:回顾性分析经骨髓穿刺及淋巴结活检确诊的4例BPDCN患者的临床特征、骨髓形态及免疫表型、治疗及预后。结果:4例患者中均有骨髓及脾脏、淋巴结累及,2例皮肤浸润,3例出现中枢神经系统浸润。骨髓中异常细胞形态可见拖尾状,免疫分型显示4例患者均表达CD56、CD4和CD123,3例患者表达CD304。1例患者拒绝化疗早期死亡;2例患者初始应用DA+VP方案治疗后均达完全缓解,其中1例在复发后应用该方案再次达完全缓解;1例患者应用减低剂量DA+VP化疗无效,之后应用维奈克拉+阿扎胞苷达完全缓解。4例患者无疾病生存期为2-7个月,总生存期为2-33个月。结论:BPDCN患者的恶性细胞多浸润骨髓、脾脏及淋巴结并具有特殊表型,且预后差。治疗方案应兼顾髓系及淋巴系,含新药的方案如BCL-2抑制剂联合去甲基化药物值得尝试。 相似文献
4.
目的探讨母细胞性浆细胞样树突状细胞肿瘤(BPDCN)的组织病理学特点、诊断与鉴别诊断。方法对2例BPDCN患者的组织标本(1例为淋巴结、骨髓活检,另1例为皮肤、淋巴结、骨髓活检)进行HE染色及常规EliVision免疫组化观察与分析。结果 2例均为男性,年龄73岁和7岁。就诊时1例无症状、多发性皮肤病损,表面呈淡红色至紫红色的斑疹、丘疹、斑块、皮下结节;另1例无皮肤病损,以浅表淋巴结肿大就诊。组织学检查示1例侵犯淋巴结和骨髓;另1例侵犯皮肤、淋巴结和骨髓。镜下瘤细胞形态类似于淋巴母细胞或原始单核细胞。免疫组化示瘤细胞CD4、CD56、CD43和CD123(+),CD117、MPO、CD68、PAX5、CD20和CD3(-)。结论 BPDCN是一种罕见类型高度侵袭性血液肿瘤,除侵犯皮肤外还侵犯骨髓和淋巴结。CD4、CD56、CD43和CD123(+),不表达系别特异性标记,应注意与急性白血病、淋巴瘤区别。 相似文献
5.
目的 探讨高危侵袭性T细胞非霍奇金淋巴瘤(T—NHL)的临床特征、治疗与预后。方法 对国际预后指数(IPI)评分为中高危或高危的54例侵袭性T-NHL患者,按WHO分类标准分型,对其进行回顾性分析。结果 T淋巴母细胞淋巴瘤(TLBL)12例(22.2%),非特殊型外周T细胞淋巴瘤(PTCL—U)31例(57.4%),肝脾T细胞淋巴瘤(HSTCL)11例(20.4%)。IPI评分中高危12例(22.2%),高危42例(77.8%);其中侵犯骨髓49例(90.7%),侵犯脑膜7例(13.0%)。治疗总体反应率为86.5%,完全缓解率为67.3%,3年总生存(OS)率为16.0%;采取造血干细胞移植治疗的患者3年OS率为44.4%,明显高于化疗组(8.3%)。多因素分析显示治疗方案的选择、能否达缓解是影响预后的重要因素。结论 T—NHL是一组高度异质性肿瘤。中高危、高危T—NHL,尤其是PTCL—U和TLBL,虽然化疗反应率较高,但远期疗效很差,需要探索新的治疗方案,自体造血干细胞移植可能是较好的选择。 相似文献
6.
目的:探讨强化维持化疗方案治疗Ⅲ-Ⅳ期儿童青少年淋巴母细胞淋巴瘤(LBL)患者的疗效及安全性。方法:回顾性分析本院2009年7月-2015年7月收治的87例Ⅲ-Ⅳ期儿童青少年LBL患者的临床资料。87例患者均采用改良NHL-BFM-90/-95方案治疗,其中62例在维持治疗阶段给予常规化疗方案设为对照组,25例在维持治疗阶段给予强化化疗方案设为强化方案组,比较2组随访5年无事件生存(EFS)率、总生存(OS)率,复发死亡情况及毒副作用发生情况。结果:2组患者随访5年EFS率和OS率比较差异无统计学意义(P>0.05);2组临床分期Ⅲ期/Ⅳ期、免疫分型T-LBL/B-LBL及中危/高危组间随访5年EFS率、OS率比较差异无统计学意义(P>0.05);2组患者随访复发率和死亡率比较差异无统计学意义(P>0.05)。强化方案组维持治疗期间Ⅲ-Ⅳ级骨髓抑制发生率显著高于对照组(P<0.05)。结论:强化维持化疗方案用于Ⅲ-Ⅳ期儿童青少年LBL患者治疗较常规维持化疗方案并未增加生存获益,且可能导致严重骨髓抑制发生风险升高。 相似文献
7.
目的评价德国NHL-BFM-90方案治疗中国儿童青少年B细胞非霍奇金淋巴瘤(BNHL)的疗效和毒性。方法20岁以下的儿童青少年B-NHL患者42例,其伯基特淋巴瘤18例,弥漫性大B细胞淋巴瘤16例,间变性大细胞淋巴瘤8例;早期病例(Ⅱ期)10例,晚期病例(Ⅲ,Ⅳ期)32例所有患者均接受NHL-BFM-90方案化疗根据临床分期、血清乳酸脱氢酶(LDH)的水平等预后因素,分为低、中和高危3组。低危组(Ⅱ期患者)接受A和B疗程交替化疗4个疗程:中危组(Ⅲ期和LDH〈500U/L的Ⅳ期患者)接受AA和BB疗程交替化疗6个疗程高危组[LDH〉500U/L的Ⅳ期患者和中危组两疗程AA、BB治疗后不能完全缓解(CR)的患者]接受AA、BB和CC疗程交替化疗6个疗程每个疗程间隔18~21d结果37例(88%)患者获得CR,5例(12%)患者获得部分缓解(PR),其中1例接受自体造血干细胞移植,3例行残留病灶放疗,1例观察,主要不良反应为骨髓抑制和黏膜炎,以AA、BB和CC疗程明显,但均可耐受中位随访20(4~89)个月,按Kaplan-Meier方法进行生存率统计,2年全组无事件生存(EFS)率为86.24%,早期患者为100%,晚期患者为80.95%。结论短疗程、高强度化疗结合中枢神经系统预防的治疗策略能明显改善儿童青少年B-NHL患者的疗效和生存率,特别是对晚期患者的疗效更明显。 相似文献
8.
卢新天 《国际输血及血液学杂志》1996,(1)
小儿非霍奇金淋巴瘤的治疗以化疗为主,目前趋向于根据不同的病理类型、免疫学类型及病期选择化疗方案。对淋巴母细胞淋巴瘤多主张采用与急性淋巴细胞白血病相似的治疗方案,对小无裂细胞淋巴瘤采用以环磷酰胺和氨甲喋呤等药物组成的方案;而大细胞性淋巴瘤的最佳治疗选择仍在探讨之中。 相似文献
9.
套细胞淋巴瘤(M C L )是2001年W H O淋巴造血组织肿瘤新分类中的一种独立的B细胞非霍奇金淋巴瘤[1],占非霍奇金淋巴瘤的5%~10%。它来源于初级淋巴滤泡未成熟生发中心前CD5(+)的B细胞或次级淋巴滤泡套区细胞,好发于中老年人。大多诊断时处于Ⅲ~Ⅳ期,有广泛性淋巴结累及,结外病变多见。B组症状易见[2,3]。临床表现有高热伴乏力,脾脏、淋巴结肿大,脾内形成瘤块,骨髓受累等。部分病例伴有外周血淋巴细胞明显增多。本文报道一例套细胞淋巴瘤骨髓浸润的患者病例,通过骨髓及外周血的形态学检查,流式细胞学检查以及骨髓活检等进行分析,从而作深入的讨论与文献复习。 相似文献
10.
淋巴瘤是原发于淋巴结或淋巴组织的恶性肿瘤,有淋巴细胞和组织细胞的大量增生,恶性程度不一[1].非霍奇金淋巴瘤(NHL)是淋巴瘤的一种,易侵犯咽淋巴环、肺及其他胸部器官、消化道、骨骼、皮肤、卵巢等[2].卵巢原发性淋巴瘤约占所有NHL的0.5%,而在所有卵巢恶性肿瘤中仅占1.5%[3],B细胞型较为多见,单侧多发[4].化疗是NHL重要的治疗手段,如NHL发生在妊娠期,易对患者及胎儿产生不同程度影响,给临床护理带来了较多挑战.2011年3月,本院血液科收治 1例妊娠合并卵巢淋巴瘤患者,现将化疗期护理报告如下. 相似文献
11.
The modified program NHL-BFM-90 in the treatment of patients with diffuse large B-cell lymphosarcoma
Magomedova AU Kravchenko SK Kremenetskaia AM Zvonkov EE Bariakh EA Margolin OV Kaplanskaia IB Vorob'ev IA Samoĭlova RS Obukhova TN Moiseeva TN Zybunova EE Gemdzhian EG Vorob'ev AI 《Terapevticheski? arkhiv》2006,78(10):44-47
AIM: To investigate efficacy of the modified protocol NHL-BFM-90 in patients with diffuse large B-cell lymphosarcoma (DLBCLS). MATERIAL AND METHODS: A total of 13 DLBCLS patients with stage II-IV of the disease with affection of lymph nodes at the disease onset (nodal lesion) and stage II with tumor size more than 10 cm (bulky disease) received first-line treatment according to the modified program NHL-BFM-90 from 2002 to 2005. The diagnosis was made by WHO criteria. RESULTS: A complete remission was achieved in 76.9% patients. Resistance to therapy was observed in the patients with bone marrow affection. The 2.5-year overall survival was 74%, 2-year event-free survival was 75% (the events were recurrence and resistance). Follow-up continued from 5 to 47 months. CONCLUSION: The efficacy of the modified protocol NHL-BFM-90 in DLBCLS patients with stage III-IV of the "nodal" disease and stage II of the "bulky" disease was high. 相似文献
12.
Bariakh EA Zvonkov EE Kremenetskaia AM Kravchenko SK Magomedova AU Obukhova TN Samoĭlova RS Vorob'ev IA Kaplanskaia IB Moiseeva TN Zybunova EE Lorie IuIu Chernova NG Mar'in DS Egorova EK Krasil'nikova BB Gabeeva NG Vorob'ev AI 《Terapevticheski? arkhiv》2005,77(7):53-58
AIM: To compare programs of chemotherapy used in adult Berkitt-like lymphoma (ABLL); to assess efficacy and toxicity of the protocol AblL-M-04. MATERIAL AND METHODS: 31 ABLL patients (23 males, 8 females, mean age 27 years) participated in the study performed in Hematological Research Center in 1995-2004. ABLL stage I, II, III and IV was diagnosed in 3, 5, 8 and 15 patients, respectively. 10 patients had diffuse large B-cell lymphoma. 9 patients received 2 to 6 courses of CHOP, 1 patient--6 courses of Pro-Mace-Cytabom, 11 patients with newly diagnosed ABLL and 5 pretreated with CHOP--NHL-BFM-90. The modified protocol ABLL-M-04 of intensive short-term therapy included 10 patients, 2 of them pretreated. RESULTS: Of 10 patients given CHOP or CHOP-like courses 9 were resistant to therapy, 2 died of rapid progression, 7 were converted to the program therapy. 5 patients on the protocol NHL-BFM-90 died after short-term improvement. None of them achieved remission. Of 10 patients with newly diagnosed ABLL treated according to NHL-BFM-90 protocol, remission was achieved in 4 patients, follow-up median--34 months (2-56). Six patients died: 4 of progression, 2 of chemotherapy complications. BLL-M-04 therapy was made in 9 patients: 7 patients persisted on the first remission, 2 patients died of chemotherapy complications. Overall duration of the treatment was 3-3.5 months. CONCLUSION: The protocol ABLL-M-04 seems to be more effective than a classic NHL-BFM-90, but this must be supported by more cases. CHOP therapy cannot be recommended for patients with ABLL because of poor efficacy (all the CHOP patients died). 相似文献
13.
Yan Gao Xian-Qi Feng Shan-Shan Liu Yu-Jie Xu Chun-Xia Mao Tian-Lan Li Feng Hou Wei Zhang 《The Journal of international medical research》2021,49(5)
Acute myeloid leukemia (AML) with T lymphoblastic lymphoma (T-LBL) is a hematologic tumor of two origins, myeloid and lymphoblastic, and is relatively rare in the same patient. We report a rare case of AML with T-LBL. After the patient was diagnosed, he received standard chemotherapy, which decreased the primitive bone marrow cell percentage from 84% to 5%; however, the enlarged superficial lymph nodes showed no obvious change in size. Immunohistochemistry revealed the following: cluster of differentiation (CD)3 (+), CD5 (+), CD7 (+), transmission disequilibrium test (TDT) (+), myeloperoxidase (MPO) (−), and lysozyme (Lys) (−). The lymph node morphology and immunohistochemical results indicated T-LBL. Therefore, the final diagnosis was AML with T-LBL, with both diseases occurring independently and concurrently. 相似文献
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15.
目的:探讨母细胞性浆细胞样树突细胞肿瘤(BPDCN)的临床表现、病理特点、治疗方案及预后。方法:回顾性分析经病理证实的5例BPDCN患者的临床病理特征、诊断治疗及预后。结果:本组5例患者中4例存在皮肤损害,5例患者均有骨髓累及。免疫组织化学检测显示,5例患者均表达CD56,4例患者表达CD4和CD123,3例患者表达CD43。经初始方案治疗后3例达完全缓解,1例达到部分缓解1个月后疾病进展,1例未缓解。2例年轻患者均进行了同胞全相合allo-PBSCT,这2例患者获得了长期生存。结论:BPDCN常见皮肤损害、骨髓受累,可表达CD56、CD3、CD123及CD43。对于合适的患者在CR1期积极进行异基因外周血干细胞移植,可能增加其获得长期生存的机会。 相似文献
16.
目的观察大剂量甲氨喋呤(MTX)联合柔红霉素、长春新碱、环磷酰胺、强的松治疗成人急性淋巴细胞性白血病的效果及毒副作用。方法观察12例成人急性淋巴细胞性白血病患者,给予MTX3g/m2联合柔红霉素、长春新碱、环磷酰胺、强的松化疗,同时给予水化、碱化、止吐、保肝、补充能量和液体、生理盐水清洁口腔、防止感染等支持治疗。结果完全缓解(CR)率58.3%,部分缓解(PR)率25.0%,总有效率83.3%。6例中枢神经系统白血病患者5例脑脊液缓解,缓解率83.3%;毒副作用较小。结论大剂量甲氨喋呤联合柔红霉素、长春新碱、环磷酰胺、强的松治疗成人急性淋巴细胞性白血病是一种安全有效的方案。 相似文献
17.
目的:研究儿童不同病理亚型非霍奇金淋巴瘤(NHL)的临床特征及预后影响因素。方法:收集2011年3月到2017年9月期间福建医科大学附属协和医院收治的初发儿童NHL 93例,按照WHO-2008淋巴系恶性肿瘤分类标准诊断,根据不同免疫标记、病理类型及肿瘤分期选择化疗方案;采用Kaplan-Meier方法计算5年无事件生存率(EFS),用Cox比例风险模型对预后影响因素进行分析。结果:93例NHL患儿中,男女比例为2.88:1,中位年龄6(0.9-13)岁,病理亚型伯基特淋巴瘤(BL)、ALK+间变大细胞淋巴瘤(ALCL)、淋巴母细胞淋巴瘤(LBL)、弥漫大B细胞淋巴瘤(DLBCL)和结外NK/T细胞淋巴瘤(ENKTL)分别为35、17、17、11和7例。在临床上,浅表淋巴结肿大为最常见的首诊表现,而腹腔瘤块(尤其是回盲部)伴LDH明显升高最常见于成熟B-NHL(B-NHL),纵膈肿物最常见于LBL,噬血细胞综合征(HPS)最常见于成熟T/NK细胞型NHL。79例完成2个疗程诱导化疗并评估,总体完全缓解(CR)率为81.01%;中位随访时间为32.5(1.0-88.5)个月,10例复发,复发率为11.90%,中位复发时间为5.9(3.4-15.7)个月;总体5年EFS为(77.1±4.9)%,T-LBL、B-LBL、成熟B淋巴细胞淋巴瘤、ALK+ALCL及ENKTL的5年EFS分别为(53.5±16.1)%、100%、(86.2±5.2)%、(87.5±8.3)%和(28.6±17.1)%。单因素分析显示,B症状、LDH水平、继发HLH、免疫分型、病理亚型、临床分期、诱导化疗是否CR等因素影响患儿的预后。多因素分析显示,诱导化疗2个疗程能否CR为独立的预后危险因素(HR0.001,95%CI:0.000-0.122)。结论:不同病理亚型的儿童NHL临床特征及预后不同,诱导化疗后能否达CR是儿童NHL独立的预后因素。 相似文献
18.
Mayo Clinic experience with allogeneic and syngeneic bone marrow transplantation, 1982 through 1990.
L Letendre H C Hoagland S B Moore M G Chen D A Gastineau M A Gertz T M Habermann M R Litzow P No?l L A Solberg 《Mayo Clinic proceedings. Mayo Clinic》1992,67(2):109-116
Between April 1982 and July 1990, 101 patients underwent allogeneic or syngeneic bone marrow transplantation at the Mayo Clinic. This patient population consisted of 30 with acute nonlymphocytic leukemia, 25 with acute lymphoblastic leukemia, 29 with chronic granulocytic leukemia, and 17 with other diseases (aplastic anemia in 7, myelodysplastic syndrome in 5, and lymphoma in 5). The results achieved in our patients who underwent transplantation in first complete remission of both acute nonlymphocytic leukemia and acute lymphoblastic leukemia compare favorably with previously reported results. Only 1 of 15 patients (7%) with acute nonlymphocytic leukemia and 2 of 8 patients (25%) with acute lymphoblastic leukemia who underwent transplantation in first complete remission had a relapse. Thus, we recommend early bone marrow transplantation during initial complete remission for patients with either of these disorders who have adverse prognostic factors. In contrast, of 12 patients with either acute nonlymphocytic leukemia or acute lymphoblastic leukemia who underwent transplantation during relapse, 11 died within 6 months. Therefore, such patients should be offered new experimental treatments. Our patients with chronic granulocytic leukemia fared better when they underwent transplantation early during the course of their disease rather than during the accelerated or blast phase. Prospective studies are needed to determine the best approach in these patients. 相似文献