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乌克兰 T 细胞非霍奇金淋巴瘤患者的前瞻性研究。

Ukrainian prospective study in patients with T-cell non-Hodgkin lymphomas.

机构信息

National Cancer Institute, Kyiv 03022, Ukraine.

出版信息

Exp Oncol. 2021 Dec;43(4):346-350. doi: 10.32471/exp-oncology.2312-8852.vol-43-no-4.17151.

Abstract

BACKGROUND

T-cell lymphoma (TCL) is a heterogeneous group of lymphoproliferative diseases that account for 10-15% of all non-Hodgkin lymphomas. The aim of the study was to analyze the incidence of TCL in Ukraine, distribution according to subtypes and to assess the results of treatment of patients with TCL depending on lymphoma subtype and clinical-and-laboratory risk factors.

PATIENTS AND METHODS

Data from 70 patients with TCL were analyzed from February 2018 to May 2021. T-cell lymphoid neoplasms were diagnosed according to the 2016 WHO classification. The patients were divided into 4 groups: 1 (A) - leukemic forms (n = 13) (received SMILE or HyperCVAD +/- auto/alloSCT); 2 (B) - nodal T-cell lymphomas (n = 43) (CHOP-like regimens); 3 (C) - cutaneous T-cell lymphomas (n = 9) (PUVA therapy, interferon, and methotrexate); 4 (D) - extranodal T-cell lymphomas (n = 5) (CHOP-like regimens). The response was determined according to the Lugano 2014 criteria.

RESULTS

According to the study results, 5-6% of all non-Hodgkin lymphoma registered in Ukraine in 2018-2020 were T-cell lymphomas. The most common subtype was peripheral TCL (61%). In the studied groups of TCL patients, the overall response rate was 50% (n = 35). 2-years event-free survival rate was 62.27%. 2-years overall survival rate was 65.76%. 18-month progression-free and overall survival in group B was higher versus groups A, C and D. The factors of unfavorable prognosis were bone marrow involvement and the expression of Ki67 > 65% (p = 0.03 and p = 0.006, respectively).

CONCLUSIONS

Histologic subtype of T-cell non-Hodgkin lymphoma influence the treatment outcome. The best overall response rate, overall survival rate, progression-free survival were in group of patients with nodal T-cell non-Hodgkin lymphomas, the worst - in patients from leukemic group. Poor prognostic factors are bone marrow involvement, and Ki-67 expression > 65%.

摘要

背景

T 细胞淋巴瘤(TCL)是一组异质性的淋巴增生性疾病,占所有非霍奇金淋巴瘤的 10-15%。本研究旨在分析乌克兰 TCL 的发病率、根据亚型的分布,并评估根据淋巴瘤亚型和临床及实验室危险因素治疗 TCL 患者的结果。

患者和方法

本研究分析了 2018 年 2 月至 2021 年 5 月期间 70 例 TCL 患者的数据。根据 2016 年世卫组织分类诊断 T 细胞淋巴肿瘤。患者被分为 4 组:1(A)-白血病形式(n=13)(接受 SMILE 或 HyperCVAD +/-auto/alloSCT);2(B)-结内 T 细胞淋巴瘤(n=43)(CHOP 样方案);3(C)-皮肤 T 细胞淋巴瘤(n=9)(PUVA 治疗、干扰素和甲氨蝶呤);4(D)-结外 T 细胞淋巴瘤(n=5)(CHOP 样方案)。根据卢加诺 2014 年标准确定反应。

结果

根据研究结果,2018-2020 年在乌克兰登记的所有非霍奇金淋巴瘤中,5-6%为 T 细胞淋巴瘤。最常见的亚型是外周 TCL(61%)。在研究的 TCL 患者组中,总缓解率为 50%(n=35)。2 年无事件生存率为 62.27%。2 年总生存率为 65.76%。与组 A、C 和 D 相比,组 B 的 18 个月无进展和总生存率更高。骨髓受累和 Ki67 表达>65%是不良预后的因素(p=0.03 和 p=0.006)。

结论

TCL 的组织学亚型影响治疗结果。结内 T 细胞非霍奇金淋巴瘤患者的总体反应率、总生存率、无进展生存率最高,白血病组患者最差。预后不良的因素是骨髓受累和 Ki-67 表达>65%。

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