Ohshima Rika, Tomita Naoto, Motohashi Kenji, Ieda Atsuko, Hyou Rie, Fujisawa Shin, Fujita Hiroyuki, Sakai Rika, Koharazawa Hideyuki, Kuwabara Hideyuki, Kanamori Heiwa, Ishigatsubo Yoshiaki
Department of Hematology, Yokohama City University Medical Center.
Rinsho Ketsueki. 2005 Jun;46(6):453-7.
We retrospectively evaluated the diagnosis and clinical courses of 8 patients with intravascular large B-cell lymphoma (IVL) diagnosed while they were alive. The median age was 67 years old (range 54 to 82). Most complaints at diagnosis were fever or dyspnea. All patients were in clinical stage IV with B symptoms and 4 patients showed performance status 4. The diagnosis of IVL was confirmed by biopsy specimens from the bone marrow in 4, lung in 2, muscle, adrenal gland, and lymph node in 1 case, respectively. Initial bone marrow involvement was found in 6 patients. Chemotherapy was performed in 7 patients. Rituximab was added to chemotherapy in 5 patients. Though 5 patients are alive at the median follow up of 12.3 months, only 1 patient is in remission. Four of 5 patients treated with Rituximab relapsed. In suspicious cases, it is important to bear IVL in mind and examine bone marrow biopsies for an early diagnosis. In addition, it is suggested that Rituximab may play only a temporary role in the treatment of IVL.
我们回顾性评估了8例生前确诊的血管内大B细胞淋巴瘤(IVL)患者的诊断及临床病程。中位年龄为67岁(范围54至82岁)。诊断时的大多数主诉为发热或呼吸困难。所有患者均处于临床IV期且伴有B症状,4例患者表现为体能状态4级。IVL的诊断分别通过4例骨髓、2例肺、1例肌肉、肾上腺及淋巴结的活检标本得以证实。6例患者发现初始骨髓受累。7例患者接受了化疗。5例患者在化疗中加用了利妥昔单抗。虽然在中位随访12.3个月时有5例患者存活,但仅有1例患者处于缓解状态。接受利妥昔单抗治疗的5例患者中有4例复发。在可疑病例中,重要的是要考虑到IVL并检查骨髓活检以进行早期诊断。此外,提示利妥昔单抗在IVL治疗中可能仅起暂时作用。