Li Yan-qiu, Yu Qin-mei, Li Jun, Yang Jin-rong, Niu Ting
Department of Hematology, West China Hospital, Sichuan University, Chengdu 610041, China.
Sichuan Da Xue Xue Bao Yi Xue Ban. 2012 May;43(3):467-9.
To improve the understanding of diagnosis and treatment of patients with primary The data of clinical features, laboratory Sjögren's syndrome (pSS) complicated with lymphoma.
findings, therapeutic response and follow-up of patients with primary Sjögren's syndrome complicated with lymphoma from January 2006 to January 2011 in our single center were retrospectively analyzed.
Totally twelve inpatients with pSS complicated with lymphoma were diagnosed, which accounted for 1.29% of newly-diagnosed lymphoma inpatients during the same period. The characteristic immunologic changes were hyperimmunoglobulinemia, hypocomplementemia and decrease of CD4 T cell number. In our study, non-Hodgkin's lymphoma (NHL) was the most common type, and the main pathological subtype was diffuse large B cell lymphoma (DLBCL). Most of the patients were in advanced stages, Ann Arbor stage IIl-IV, at diagnosis. Extranodal involvement was common, most frequently in the livers and the lungs. All of the patients received combination chemotherapy. Most of the NHL patients received CHOP/R-CHOP-like regimens, and the Hodgkin's lymphoma (HL) patient received AVD regimen. The median follow-up time was 27 months (range 1-56 months). In terms of median survival time and overall survival there were no statistical significant differences between both low C3 and low C4 group and control group (P > 0.05). In terms of median survival time and overall survival there were no statistical significant differences between rituximab treatment group and control group (P > 0.05).
The patients with pSS complicated with lymphoma were not uncommon clinically. Hypocomplementemia could not be identified as a risk factor for the prognosis of pSS complicated with lymphoma in our study. Although expected prognosis of these patients was unfavorable, we found that treatment with rituximab combination chemotherapy could not improve the therapeutic effects and survival of patients with pSS complicated with lymphoma.
提高对原发性干燥综合征(pSS)合并淋巴瘤患者诊断和治疗的认识。
回顾性分析2006年1月至2011年1月在我院单中心收治的原发性干燥综合征合并淋巴瘤患者的临床特征、实验室检查结果、治疗反应及随访资料。
共诊断出12例pSS合并淋巴瘤患者,占同期新诊断淋巴瘤住院患者的1.29%。特征性免疫改变为高免疫球蛋白血症、低补体血症及CD4 T细胞数量减少。本研究中,非霍奇金淋巴瘤(NHL)最为常见,主要病理亚型为弥漫大B细胞淋巴瘤(DLBCL)。大多数患者诊断时处于晚期,Ann Arbor分期为III-IV期。结外受累常见,最常累及肝脏和肺。所有患者均接受联合化疗。大多数NHL患者接受CHOP/R-CHOP样方案,霍奇金淋巴瘤(HL)患者接受AVD方案。中位随访时间为27个月(范围1-56个月)。低C3和低C4组与对照组在中位生存时间和总生存率方面无统计学显著差异(P>0.05)。利妥昔单抗治疗组与对照组在中位生存时间和总生存率方面无统计学显著差异(P>0.05)。
pSS合并淋巴瘤患者临床并不少见。在本研究中,低补体血症不能被确定为pSS合并淋巴瘤预后的危险因素。尽管这些患者的预期预后不佳,但我们发现利妥昔单抗联合化疗不能提高pSS合并淋巴瘤患者的治疗效果和生存率。