【摘要】 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。更多还原

【Abstract】 Objective To analyse the clinical characteristics,treatments and prognosis of patients with T-cell non-Hodgkins lymphoma(NHL)in intermediate-high and high risk.Methods Fifty-four patients with T-cell NHL classified intermediate-high and high risk were retrospectively analyzed.Results According to WHO classification criteria,there were 12 cases of T-lymphoblastic lymphoma(TLBL),31 peripheral T- cell lymphoma unspecified(PTCL-U),and 11 hepatosplenic T-cell lymphoma(HSTCL).The IP1 were 12 cases of intermediate-high risk and 42 high risk.Of them,49 cases were bone marrow affected and 7 CNS af- fected.The response rate(RR)for the whole group was 86.5%,complete remission(CR)rate 67.3%, and 3-year survival rate 16.0%.The 3-year survival rates for haematopoietic stem cell transplantation and chemotherapy groups were 44.4% and 8.3%,respectively.Multi-factor analysis showed that choice of thera- py modality,and achievement of remission were significant factors for overall survival.Conclusion T-NHL is a group of heterogeneous malignancies.The response rate of intermediate-high and high risk T-NHL,espe- cially PTCL-U and LTBL,is not low,but its long term outcome is poor.New treatment modality needs to be explored for these patients,and autologous HSCT is perhaps a good choice.更多还原