Zhang Wei, Wang Jing, Wan Wei, Wan Wen-Li, Wang Ji-Jun, Hu Kai, Ke Xiao-Yan
Department of Hematology, Peking University Third Hospital, Beijing 100191, China.
Department of Hematology, Peking University Third Hospital, Beijing 100191, China. E-mail:
Zhongguo Shi Yan Xue Ye Xue Za Zhi. 2013 Dec;21(6):1448-53. doi: 10.7534/j.issn.1009-2137.2013.06.015.
This study was aimed to explore the clinical features and related prognostic factors of follicular lymphoma (FL). The total of 59 newly diagnosed FL patients were analyzed retrospectively in term of age, sex, clinical manifestation, laboratory data, pathological examination, clinical stage and so on, so as to find out the related prognostic factors. The results showed that the median age of the 59 patients was 55 years, among them the male-female ratio was 1: 1.36. Among the 64.4% cases with the involvement outside lymphonode , the bone marrow involvement accounted for 28.8%, while the involvement of gastrointestinal tract and skeleton was in the second place. The rate of BCL-2/JH gene rearrangement was 30.3%, III-IV of clinical stage accounted for 71.2% in these FL patients. During the follow up of the 56 patients, OR and CR rates were 96.4% and 80.3% respectively, 5 year-and 10 year overall survival rates were 88.2% and 74.1% respectively, the relapse rate was 33.9%. Univariate analysis showed that the age, the longest diameter of involved node, gastrointestinal involvement, serum lactate dehydrogenase, ECOG, IPI, aaIPI, FLIPI, FLIPI2 and whether initial therapy could achieve CR or not were influencing factors of prognosis for FL patients. Multivariant analysis showed that the gastrointestinal involvement, IPI, aaIPI and whether initial therapy could achieve CR or not were independent prognostic factors for OS. The relative mortality risk of patients without CR was 70 times of patient with CR. It is concluded that the newly diagnosed FL is more observed in middle to old aged females, displaying frequent bone marrow involvement, less frequent BCL-2/JH gene rearrangement, III-IV of clinical staging, and high relapse rate, but longer survival time. The gastrointestinal involvement, IPI, aaIPI and whether CR can be achieved or not after initial therapy are independent prognostic factors for FL patients.
本研究旨在探讨滤泡性淋巴瘤(FL)的临床特征及相关预后因素。回顾性分析59例新诊断FL患者的年龄、性别、临床表现、实验室数据、病理检查、临床分期等,以找出相关预后因素。结果显示,59例患者的中位年龄为55岁,男女比例为1:1.36。在64.4%有淋巴结外受累的病例中,骨髓受累占28.8%,胃肠道和骨骼受累位居其次。BCL-2/JH基因重排率为30.3%,这些FL患者中临床分期III-IV期占71.2%。在对56例患者的随访中,OR率和CR率分别为96.4%和80.3%,5年和10年总生存率分别为88.2%和74.1%,复发率为33.9%。单因素分析显示,年龄、受累淋巴结最长径、胃肠道受累情况、血清乳酸脱氢酶、ECOG、IPI、aaIPI、FLIPI、FLIPI2以及初始治疗能否达到CR是FL患者预后的影响因素。多因素分析显示,胃肠道受累情况、IPI、aaIPI以及初始治疗能否达到CR是OS的独立预后因素。未达到CR的患者相对死亡风险是达到CR患者的70倍。结论是,新诊断的FL在中老年女性中更为常见,骨髓受累频繁,BCL-2/JH基因重排较少,临床分期为III-IV期,复发率高,但生存时间较长。胃肠道受累情况、IPI、aaIPI以及初始治疗后能否达到CR是FL患者的独立预后因素。