57例非特异性外周T细胞淋巴瘤的临床特征与生存分析

目的 探讨非特异性外周T细胞淋巴瘤(PTCL-NOS)的临床特征、治疗方法、疗效及预后.方法 收集57例PTCL-NOS的临床和随访资料,根据2008年美国国立综合癌症网络(NCCN)指南对全部病例的临床资料重新进行评估,并进行回顾性分析,采用Log rank检验和多因素Cox回归模型分析临床特征与预后的关系.结果 57例PTCL-NOS患者男女比例为2.17∶1,中位年龄为44岁.化疗和放疗联合治疗9例(15.8%),单纯化疗43例(75.4%),单纯放疗3例(5.3%),支持治疗2例(2.5%).完全缓解率为60.0%,有效率为87.3%.中位生存期为36.0个月,1、3、5年生存率分别为68.0%、48.0%和24.3%.单因素分析结果显示,B症状、骨髓侵犯、结外侵犯、东部肿瘤协作组(ECOG)体力状况评分、Ann Arbor分期、乳酸脱氢酶(LDH)水平、外周T细胞淋巴瘤预后指数(PIT)与PTCL-NOS患者的预后有关.多因素Cox回归分析结果显示,PIT评分是PTCL-NOS患者预后的影响因素,OR为2.312(P=0.020).结论 PTCL-NOS患者采用常规化疗近期疗效较好,但远期生存率低,预后不良,需进一步探索新的治疗策略.

Clinical characteristics and survival of peripheral T-cell lymphoma-not otherwise specified:a report of 57 cases

Objective To analyze the clinical characteristics and survival data of 57 patients with peripheral T-cell lymphoma-not otherwise specified(PTCL-NOS).Methods The medical records of 57 patients with PTCL-NOS classified according to the revised REAL-WHO criteria.treated from Jan 1993 to Dec 2007 at the First and the Third affiliated Hospitals of Medical School of Xi'an Jiaotong University.were retrospectively evaluated by K-M univariate and COX multivariate analysis.Results 39 of the patients (68.4%)were males and 18(31.6%)were females,aged 44(3-88).Nine of the 57 patients(15.8%)were treated with chemo-radiotherapy,43(75.4%)with chemotherapy,3(5.3%)with radiotherapy,and 2 with supported treatment alone(2.5%).The overall response rate was 87.3%,with a complete remission (CR)rate of 60.0%in 55 evaluable cases.The 1-,3-,and 5-year overall survival(OS)rates were 67.0%.48.0%and 24.3%,respectively,with a median follow-up of 30.4 months(ranged 1-100months).The median survival time(MST)was 36.0 months.Multivariate analysis showed that theprognostic index for T cell lymphoma(PIT)score wag an independent prognostic factor for PTCL-NOS(P<0.05),but bone marrow involvement,performance status,extranodal involvement,stage,B symptom were not independent prognostic factors.Conclusion Although conventional chemotherapy yields a high response rate for PTCL-NOS.the long-term survival is still low and further investigation for optional treatment is needed.