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外周 T 细胞淋巴瘤患者的临床特征与预后分析。

Analysis of clinical characteristics and prognosis of patients with peripheral T-cell lymphoma.

机构信息

Department of Lymphoma, Xinjiang Medical University Affiliated Tumor Hospital, Urumqi, Xinjiang, China.

出版信息

Medicine (Baltimore). 2021 Apr 2;100(13):e25194. doi: 10.1097/MD.0000000000025194.

Abstract

BACKGROUND

This study aimed to explore the clinical characteristics, therapeutic efficacy and prognostic factors of peripheral T-cell lymphoma (PTCL).

METHODS

The clinical data of 119 PTCL patients who were admitted to the Xinjiang Medical University Affiliated Tumor Hospital from January 2010 to December 2017 were retrospectively analyzed, including the clinical characteristics, therapeutic efficacy, prognosis-related factors and treatments. Among the patients, 98 patients received antharcyclines-based therapeutic protocols, including Cyclophosphamide, Pirarubicin, Vincristine, Prednisone (CHOP) protocol and Cyclophosphamide, Pirarubicin, Vincristine, Prednisone, Etoposide (CHOPE) protocol, with median follow-up time of 32.5 months (2-166 months). The patients' clinical characteristics were analyzed, and COX ratio risk regression model was adopted to analyze the prognostic factors related with the survival rate of PTCL patients.

RESULTS

The 5-year overall survival (OS) rate was 46.4% and progression-free survival (PFS) rate was 42.7% in the 98 patients, and there were insignificant differences between patients with CHOP protocol and those with CHOPE protocol in the 5-year OS and PFS rates (OS: P = 0.197, PFS: P = 0.663). The univariate analysis results showed that different pathological types, Ann Arbor stage, Eastern Cooperative Oncology Group (ECOG) score ≥ 2, the number of extranodal lymphomas involved, Lactic dehydrogenase (LDH) level, presence/absence of bone marrow involved, international prognostic index (IPI) score, β2 microglobulin (β2-MG) level and hemoglobin (Hb) level were poor prognosis factors influencing patients' OS and PFS rates (P all < .05). Multivariate analysis demonstrated that different pathological types, Ann Arbor stage, presence/absence of bone marrow involved and Hb level were independent prognostic indicators influencing patients' OS and PFS rates (P all < .05).

CONCLUSION

PTCL is poor in therapeutic efficacy and prognosis, and different pathological types, Ann Arbor stage, presence/absence of bone marrow involved and Hb level are related with the prognosis of PTCL patients. Anemia occurring before the treatment is an important predictive indicator influencing the prognosis of PTCL patients and patients who experience anemia will be poor in prognosis.

摘要

背景

本研究旨在探讨外周 T 细胞淋巴瘤(PTCL)的临床特征、治疗效果和预后因素。

方法

回顾性分析 2010 年 1 月至 2017 年 12 月新疆医科大学附属肿瘤医院收治的 119 例 PTCL 患者的临床资料,包括临床特征、治疗效果、预后相关因素和治疗方法。其中 98 例患者接受蒽环类药物为基础的治疗方案,包括环磷酰胺、吡柔比星、长春新碱、泼尼松(CHOP)方案和环磷酰胺、吡柔比星、长春新碱、泼尼松、依托泊苷(CHOPE)方案,中位随访时间为 32.5 个月(2-166 个月)。分析患者的临床特征,采用 COX 比例风险回归模型分析与 PTCL 患者生存率相关的预后因素。

结果

98 例患者的 5 年总生存率(OS)为 46.4%,无进展生存率(PFS)为 42.7%,CHOP 方案与 CHOPE 方案患者的 5 年 OS 和 PFS 率无显著性差异(OS:P=0.197,PFS:P=0.663)。单因素分析结果显示,不同的病理类型、Ann Arbor 分期、东部肿瘤协作组(ECOG)评分≥2、结外淋巴瘤受累数、乳酸脱氢酶(LDH)水平、骨髓受累情况、国际预后指数(IPI)评分、β2 微球蛋白(β2-MG)水平和血红蛋白(Hb)水平是影响患者 OS 和 PFS 率的不良预后因素(P 均<0.05)。多因素分析显示,不同的病理类型、Ann Arbor 分期、骨髓受累情况和 Hb 水平是影响患者 OS 和 PFS 率的独立预后指标(P 均<0.05)。

结论

PTCL 治疗效果和预后均较差,不同的病理类型、Ann Arbor 分期、骨髓受累情况和 Hb 水平与 PTCL 患者的预后有关。治疗前发生贫血是影响 PTCL 患者预后的重要预测指标,发生贫血的患者预后较差。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ddb3/8021354/150e3818ca44/medi-100-e25194-g001.jpg

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