Ying Zhi-Tao, Zheng Wen, Wang Xiao-Pei, Xie Yan, Tu Mei-Feng, Lin Ning-Jing, Ping Ling-Yan, Liu Wei-Ping, Deng Li-Juan, Zhang Chen, Zhu Jun, Song Yu-Qin
Lymphoma Department, Peking University Cancer Hospital & Institute, Beijing, People's Republic of China.
Chin J Cancer. 2012 Jul;31(7):348-53. doi: 10.5732/cjc.011.10469. Epub 2012 Jun 14.
Mantle cell lymphoma(MCL), a special type of non-Hodgkin's lymphoma, is incurable through conventional treatment. This study aimed to analyze the clinical features, therapeutic responses, and prognosis of patients with MCL. Clinical data of 30 patients with MCL treated in our hospital between April 2006 and July 2011 were analyzed. Eighteen patients were treated with CHOP plus rituximab (R-CHOP) regimen, 12 underwent conventional chemotherapy. The median age of the 30 patients was 58 years, 23 were men, all patients had Cyclin D1 overexpression, 29 (96.7%) had advanced disease, 11 (36.7%) had bone marrow involvement, 9 (30.0%) had gastrointestinal involvement, and 15 (50.0%) had splenomegaly. The complete response(CR) rate and overall response rate(ORR) were significantly higher in patients undergoing R-CHOP immunochemotherapy than in those undergoing conventional chemotherapy (38.9% vs. 16.7%, P = 0.187; 72.2% vs. 41.4%, P = 0.098). The difference of 2-year overall survival rate between the two groups was not significant (P = 0.807) due to the short follow-up time. The 2-year progression-free survival (PFS) rate was higher in R-CHOP group than in conventional chemotherapy group (53% vs. 25%, P = 0.083), and was higher in patients with a lower mantle cell lymphoma international prognostic index (MIPI) (51% for MIPI 0-3, 33% for MIPI 4-5, and 0% for MIPI 6-11, P = 0.059). Most patients with MCL were elderly; in an advanced stage; showed a male predominance; and usually had bone marrow involvement, gastrointestinal involvement, or splenomegaly. R-CHOP regimen could improve the CR rate and ORR of MCL patients. MIPI can be a new prognostic index for predicting the prognosis of advanced MCL.
套细胞淋巴瘤(MCL)是一种特殊类型的非霍奇金淋巴瘤,常规治疗难以治愈。本研究旨在分析MCL患者的临床特征、治疗反应及预后。分析了2006年4月至2011年7月在我院接受治疗的30例MCL患者的临床资料。18例患者接受CHOP加利妥昔单抗(R-CHOP)方案治疗,12例接受传统化疗。30例患者的中位年龄为58岁,男性23例,所有患者均有细胞周期蛋白D1过表达,29例(96.7%)为晚期疾病,11例(36.7%)有骨髓受累,9例(30.0%)有胃肠道受累,15例(50.0%)有脾肿大。接受R-CHOP免疫化疗的患者完全缓解(CR)率和总缓解率(ORR)显著高于接受传统化疗的患者(38.9%对16.7%,P = 0.187;72.2%对41.4%,P = 0.098)。由于随访时间短,两组2年总生存率差异无统计学意义(P = 0.807)。R-CHOP组2年无进展生存率(PFS)高于传统化疗组(53%对25%,P = 0.083),套细胞淋巴瘤国际预后指数(MIPI)较低的患者PFS更高(MIPI 0-3为51%,MIPI 4-5为33%,MIPI 6-11为0%,P = 0.059)。大多数MCL患者为老年人,处于晚期,以男性为主,通常有骨髓受累、胃肠道受累或脾肿大。R-CHOP方案可提高MCL患者的CR率和ORR。MIPI可作为预测晚期MCL预后的新的预后指标。