15例伯基特淋巴瘤临床报告

目的：观察和分析１５例Ｂｕｒｋｉｔ′ｓ淋巴瘤的临床特征和治疗转归。方法：男１２例，女３例，以儿童为主，≤１５岁１１例（７３．３％），＞１５岁４例（２６．７％），中位年龄１２岁。以晚期为主，Ⅲ＋Ⅳ期１１例（７３．３％）。首发部位多见于颌面部及外周淋巴结。有Ｂ症状者５例（３３．３％），有骨髓侵犯者４例（２６．７％），中枢神经系统侵犯者１例，有结外多器官侵犯者５例（３３．３％）。１５例均采用了联合化疗，以ＣＯＭ或ＣＯＭＰ及ＢＡＣＯＰ方案为主。结果：ＣＲ５例，ＰＲ４例，总缓解率６０％，中位缓解期８个月。全组中位生存期７个月，２年生存率４２．５％，５年生存率２３．１％。早期（Ⅰ＋Ⅱ期）及化疗有效者（ＣＲ＋ＰＲ）较晚期（Ⅲ＋Ⅳ期）、化疗无效者（ＳＤ＋ＰＤ）中位生存期明显延长。有Ｂ症状、骨髓侵犯、中枢神经系统侵犯及结外多器官侵犯者中位生存期明显缩短。结论：我国Ｂｕｒｋｉｔ′ｓ淋巴瘤晚期、多器官侵犯者多，较非洲儿童预后差，但经联合化疗尤大剂量化疗能取得较好的疗效，能适当延长生存期。

Clinical Study on Burkitts Lymphoma-A Report of 15 Cases

Objective: The clinical features,treatment and prognosis of 15 cases of Burkitts lymphoma were analysed retrospectively. Methods: There were 12 cases of male and 3 of female. Most of the patients were children with a median age of 12 years and mostly of advanced disease occurred chiefly in the maxillofacial region and peripheral lymph nodes.The patients with B symptoms were found in 5 cases,bone marrow involvement 4 cases, central nervous system 1 case and extranodal organs 5 cases. All the patients were treated by combination chemotherapy (COM,COMP and BACOP). Results: Complete remission (CR), partial remission (PR) were achieved in 5 and 4 cases respectively with an overall responsive rate of 60%. The median responsive period was 8 months, and 2-, 5-year survival rates were 42.5%and 23.1%respectively. The median responsive periods of the early stages (I and II) and the patients with chemotherapeutic effect were prolonged than those of the patients of late stage or without effect of chemotherapy. The median responsive period of the patients with B symptoms, bone marrow, central nervous system and extranodal organ involvements were shortened significantly. Conclusion: Our patients with Burkitts lymphoma were much in their advanced stage and with multiple organs involvement and with poor prognosis than the African young patients. With high dose chemotherapy a better results and longer survival time would be achieved.