[临床病理特征与转归：21例妊娠合并淋巴瘤分析]

[Clinicopathological features and outcomes: analysis of 21 cases of lymphoma in pregnancy].

作者信息

Gui Lin, Shi Yuankai, He Xiaohui, Zhou Liqiang, Dong Mei, Zhou Shengyu, Yuan Peng, Liu Peng, Yang Jianliang, Zhang Changgong, Qin Yan, Yang Sheng

机构信息

Department of Medical Oncology, Cancer Institute/Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College; Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs,Beijing 100021, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2015 Feb 10;95(6):425-9.

PMID:25916778

Abstract

OBJECTIVE

To evaluate the clinicopathological features and outcomes of lymphoma in pregnancy.

METHODS

A total of 21 patients with lymphoma in pregnancy were diagnosed and treated at our hospital between January 1999 and January 2012. The clinicopathological data were analyzed retrospectively.

RESULTS

There were 11 cases of Hodgkin's lymphoma (HL) and 10 cases of nodular sclerosis classical Hodgkin's lymphoma (NSCHL). And, among 10 cases of non-Hodgkin's lymphomas (NHL), there were diffuse large B cell lymphoma (n = 6),B-cell lymphoma, non-classifiable with features intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma (n = 1), small lymphocytic lymphoma (n = 1), anaplastic large cell lymphoma with anaplastic lymphoma kinase (ALK) positive (n = 1) and T-cell lymphoblastic lymphoma (n = 1). The median age was 26(22-35) years.Superficial lymphadenopathy was more common in HL than in NHL (10/11 vs 3/10, P = 0.008). At diagnosis, bulky disease and extranodal involvement were more prevalent in NHL than in HL (8/10 vs 2/11, P = 0.009; 7/10 vs 2/11, P = 0.030). All patients received chemotherapy and those with early stages also had combined radiotherapy. Ten patients with HL and 6 patients with NHL achieved complete remission. During a median follow-up of 90 months for HL, the 5-year progression-free survival (PFS) and overall survival (OS) rates were 87.5% and 100% respectively. And during a median follow-up of 31 months for NHL, the 2-year PFS and OS rates were 66.7% and 77.8% respectively. The values of PFS and OS of NHL were inferior to those of HL (P = 0.073 and P = 0.066 respectively).One case of HL and 1 case of NHL received chemotherapy in the second trimester. The patients and their children experienced good outcomes.

CONCLUSIONS

NSCHL is the most prevalent subtype of HL during pregnancy. B cell lymphoma and aggressive subtypes are most common for NHL during pregnancy. The outcomes of NHL are inferior to those of HL during pregnancy.

摘要

目的

评估妊娠期淋巴瘤的临床病理特征及预后。

方法

1999年1月至2012年1月期间，我院共诊断并治疗了21例妊娠期淋巴瘤患者。对其临床病理资料进行回顾性分析。

结果

11例霍奇金淋巴瘤（HL），其中10例为结节硬化型经典霍奇金淋巴瘤（NSCHL）。10例非霍奇金淋巴瘤（NHL）中，弥漫大B细胞淋巴瘤6例，介于弥漫大B细胞淋巴瘤和伯基特淋巴瘤之间特征不可分类的B细胞淋巴瘤1例，小淋巴细胞淋巴瘤1例，间变性淋巴瘤激酶（ALK）阳性的间变性大细胞淋巴瘤1例，T细胞淋巴母细胞淋巴瘤1例。中位年龄为26（22 - 35）岁。HL中浅表淋巴结肿大比NHL更常见（10/11对3/10，P = 0.008）。诊断时，NHL中大包块病变和结外受累比HL更普遍（8/10对2/11，P = 0.009；7/10对2/11，P = 0.030）。所有患者均接受了化疗，早期患者还联合了放疗。10例HL患者和6例NHL患者实现完全缓解。HL患者中位随访90个月，5年无进展生存率（PFS）和总生存率（OS）分别为87.5%和100%。NHL患者中位随访31个月，2年PFS和OS率分别为66.7%和77.8%。NHL的PFS和OS值低于HL（分别为P = 0.073和P = 0.066）。1例HL和1例NHL在孕中期接受了化疗。患者及其子女预后良好。