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淋巴浆细胞淋巴瘤的临床特征和治疗结果:韩国单中心经验。

Clinical features and treatment outcomes of lymphoplasmacytic lymphoma: a single center experience in Korea.

机构信息

Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam-Gu, Seoul, South Korea.

出版信息

Ann Hematol. 2010 Oct;89(10):1011-8. doi: 10.1007/s00277-010-0978-1. Epub 2010 May 7.

Abstract

Lymphoplasmacytic lymphoma (LPL) constitutes less than 5% of all non-Hodgkin lymphomas, and little is known about clinical features and treatment outcomes for patients with LPL in East Asia. In this study, we summarize our experiences managing patients diagnosed with LPL in Korea. A retrospective analysis was performed using data for 22 patients with LPL diagnosed at Samsung Medical Center. LPL was more common among males (77.3%), with a median age of diagnosis of 63 years (range 26-86). The most common presenting symptom was fatigue related to anemia (59.1%), and the bone marrow was commonly involved at diagnosis (90.9%). IgM paraproteinemia was found in 15 patients, and only one patient had anti-hepatitis C virus. Although some patients could be observed without treatment, the majority of patients required systemic treatment. Chlorambucil alone and cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP) or CHOP-like combination chemotherapy was frequently used as a first-line treatment, and a fludarabine-based regimen was commonly used as salvage therapy. However, responses to those treatments were not satisfactory. Even patients who could be monitored without therapy became refractory to salvage therapies once their disease progressed. Eight patients died due to disease progression, and the median overall survival was 70.8 months (95% CI: 31.4-109.2 months). This study describes the clinical features and treatment outcome of LPL in Korea. The treatment approach was too heterogeneous to draw firm conclusions, however, and treatment recommendations in the future should utilize a uniform treatment strategy.

摘要

淋巴浆细胞淋巴瘤(LPL)构成所有非霍奇金淋巴瘤的不到 5%,对于东亚地区 LPL 患者的临床特征和治疗结果知之甚少。在本研究中,我们总结了在韩国管理 LPL 患者的经验。使用在三星医疗中心诊断为 LPL 的 22 例患者的数据进行了回顾性分析。LPL 在男性中更为常见(77.3%),中位诊断年龄为 63 岁(范围 26-86 岁)。最常见的表现症状是与贫血相关的疲劳(59.1%),并且诊断时骨髓通常受累(90.9%)。15 例患者存在 IgM 单克隆丙种球蛋白血症,仅有 1 例患者存在丙型肝炎病毒抗体。尽管有些患者可以不接受治疗而进行观察,但大多数患者需要接受系统治疗。单独使用苯丁酸氮芥和环磷酰胺、多柔比星、长春新碱和泼尼松(CHOP)或 CHOP 样联合化疗常作为一线治疗,氟达拉滨为基础的方案常作为挽救性治疗。然而,这些治疗的反应并不令人满意。即使那些可以在没有治疗的情况下进行监测的患者,一旦疾病进展,也会对挽救性治疗产生耐药性。8 例患者因疾病进展而死亡,中位总生存期为 70.8 个月(95%CI:31.4-109.2 个月)。本研究描述了韩国 LPL 的临床特征和治疗结果。然而,治疗方法过于多样化,无法得出明确的结论,因此,未来的治疗建议应该采用统一的治疗策略。

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