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14 例肝脾 γ δ T 细胞淋巴瘤患者的临床特征和治疗结果。

Clinical features and treatment outcomes of 14 patients with hepatosplenic γ δ T-cell lymphoma.

机构信息

The First Affiliated Hospital of Soochow University, Suzhou, China.

出版信息

J Cancer Res Clin Oncol. 2021 Nov;147(11):3441-3445. doi: 10.1007/s00432-021-03587-6. Epub 2021 Apr 15.

Abstract

BACKGROUND

Hepatosplenic γ δ T-cell lymphoma (HSTCL) is a rare subtype of peripheral T-cell lymphoma (PTCL) with aggressive clinical behavior. To date, no standard therapy for HSTCL has been established. This study analyzed the clinical features, treatment, and prognosis for patients with HSTCL to determine the best therapeutic approach.

METHODS

We reviewed the clinical characteristics, treatments, and responses to treatment of patients in our center between January 2001 and June 2021, and also reviewed related literature.

RESULTS

Median patient age was 38 years (range 16-60 years) and the patients included eight males and six females. HSTCL in these patients typically presented with B symptoms (71.4%), splenomegaly (100%), and hepatomegaly (50.0%), but lymphadenopathy was extremely rare. In these patients, routine laboratory testing showed elevated lactate dehydrogenase (71.4%), liver dysfunction (42.9%), and decreased fibrinogen (35.7%). In the induction phase, five of the 14 patients received chemotherapy regimens containing anthracycline (CHOP, or CHOP plus bortezomib or Chidamide), and six were treated with non-CHOP chemotherapy. Seven patients responded to induction treatment, four of whom received allogeneic hematopoietic cell transplantation and then achieved a complete response in the consolidation phase. survival time of patients who received alloHCT range from 10 to 27 months.

CONCLUSION

Hepatosplenic γ δ T-cell lacks a standard therapy and is often refractory to conventional chemotherapy regimens. Intensive induction chemotherapy followed by hematopoietic cell transplantation may improve the prognosis of HSTCL.

摘要

背景

肝脾 γ δ T 细胞淋巴瘤(HSTCL)是一种侵袭性临床行为的外周 T 细胞淋巴瘤(PTCL)的罕见亚型。迄今为止,尚未建立 HSTCL 的标准治疗方法。本研究分析了 HSTCL 患者的临床特征、治疗方法和治疗反应,以确定最佳治疗方法。

方法

我们回顾了 2001 年 1 月至 2021 年 6 月期间我们中心患者的临床特征、治疗方法和治疗反应,并复习了相关文献。

结果

中位患者年龄为 38 岁(范围 16-60 岁),包括 8 名男性和 6 名女性。这些患者的 HSTCL 通常表现为 B 症状(71.4%)、脾肿大(100%)和肝肿大(50.0%),但淋巴结肿大极为罕见。在这些患者中,常规实验室检查显示乳酸脱氢酶升高(71.4%)、肝功能异常(42.9%)和纤维蛋白原降低(35.7%)。在诱导期,14 例患者中有 5 例接受了含蒽环类药物的化疗方案(CHOP 或 CHOP 加硼替佐米或 Chidamide),6 例接受了非 CHOP 化疗。7 例患者对诱导治疗有反应,其中 4 例接受了异基因造血细胞移植,然后在巩固期达到完全缓解。接受 alloHCT 的患者的生存时间为 10 至 27 个月。

结论

肝脾 γ δ T 细胞缺乏标准治疗方法,通常对常规化疗方案耐药。强化诱导化疗后进行造血细胞移植可能改善 HSTCL 的预后。

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