Zaimoku Yoshitaka, Takahashi Wakana, Iwaki Noriko, Saito Chizuru, Yoshida Akiyo, Aoki Go, Yamaguchi Masaki, Nakao Shinji
a Cellular Transplantation Biology, Kanazawa University , Kanazawa , Japan ;
b Department of Hematology , Ishikawa Prefectural Central Hospital , Kanazawa , Japan.
Leuk Lymphoma. 2016 Jul;57(7):1625-32. doi: 10.3109/10428194.2015.1088649. Epub 2016 Jan 4.
Human herpesvirus-8-unrelated primary effusion lymphoma characterized by lymphomatous effusion without nodal lesions occasionally exhibits spontaneous remission. To elucidate the factors associated with a good prognosis, this study analyzed the clinical parameters of four patients treated in the department and 109 patients reported in case reports. The median age was 71 years and the median overall survival was 20 months. Patients possessing two independent favorable factors, an elderly status (≥ 70 years) and low serum lactate dehydrogenase (< 500 IU/L) showed a markedly higher 1-year survival than patients lacking either of the two factors in the absence of chemotherapy (94% vs 20%, p = 3 × 10(-5)), which was similarly observed in the chemotherapy group (94% vs 51%, p = 0.002). The use of rituximab was also a strong predictor of survival (89% vs 49%, p = 7 × 10(-6)). Elderly patients not exhibiting an increased lactate dehydrogenase may represent a benign sub-group of effusion lymphoma, which do not require chemotherapy to achieve remission.
以无淋巴结病变的淋巴瘤性积液为特征的人疱疹病毒8型无关的原发性渗出性淋巴瘤偶尔会出现自发缓解。为了阐明与良好预后相关的因素，本研究分析了该科室治疗的4例患者及病例报告中报道的109例患者的临床参数。中位年龄为71岁，中位总生存期为20个月。在未进行化疗的情况下，具备两个独立有利因素（老年状态（≥70岁）和低血清乳酸脱氢酶（<500 IU/L））的患者1年生存率明显高于缺乏这两个因素之一的患者（94%对20%，p = 3×10⁻⁵），化疗组也观察到类似情况（94%对51%，p = 0.002）。使用利妥昔单抗也是生存的有力预测因素（89%对49%，p = 7×10⁻⁶）。乳酸脱氢酶未升高的老年患者可能代表渗出性淋巴瘤的一个良性亚组，无需化疗即可实现缓解。
