Parker D, Alison D L, Barnard D L, Child J A, Dovey G, Farish J, Norfolk D R, O'Brien C J, Parapia L A, Sharp J
Clinical Oncology Unit, Bradford University, UK.
Hematol Oncol. 1994 Jan-Feb;12(1):15-27. doi: 10.1002/hon.2900120104.
Eighty-eight patients with low grade non-Hodgkin's lymphoma were followed for a median period of 63 months. Sixty-eight per cent of the group were centrocytic/centroblastic B cell lymphomas by the updated Kiel classification. Fifty-one (58 per cent) of the patients were stage IV by the Ann Arbor classification. In 18 of these patients the bone marrow was the only site of extranodal involvement. Univariate survival analysis showed that the sum of involved sites was more discriminatory than Ann Arbor stage. Analysis by site of involvement showed that the liver and other intraabdominal sites were associated with worse survival than involvement of peripheral lymph nodes. Bone marrow and spleen involvement were not significantly associated with short survival. Increasing age at presentation was strongly associated with shorter survival and was also inversely correlated with serum albumin. Both low absolute lymphocyte count (< 1.0 x 10(9)/l), low serum IgG level (< 10 g/l) and low total immunoglobulins on presentation were significantly associated with short survival. Multivariate analysis showed that age, serum albumin and number of involved sites gave the best survival prediction. The sum of involved sites, immunoglobulin level and absolute lymphocyte count may be useful objective markers of prognosis in low-grade non-Hodgkin's lymphoma.
88例低度非霍奇金淋巴瘤患者接受了为期63个月的中位随访。根据更新后的基尔分类，该组68%为中心细胞/中心母细胞B细胞淋巴瘤。根据安阿伯分类，51例（58%）患者为IV期。在这些患者中，有18例骨髓是结外受累的唯一部位。单因素生存分析显示，受累部位总数比安阿伯分期更具鉴别力。按受累部位分析表明，肝脏和其他腹腔内部位受累与外周淋巴结受累相比，生存期更差。骨髓和脾脏受累与生存期短无显著相关性。就诊时年龄增加与生存期缩短密切相关，且与血清白蛋白呈负相关。就诊时绝对淋巴细胞计数低（<1.0×10⁹/L）、血清IgG水平低（<10g/L）和总免疫球蛋白低均与生存期短显著相关。多因素分析显示，年龄、血清白蛋白和受累部位数量对生存期的预测效果最佳。受累部位总数、免疫球蛋白水平和绝对淋巴细胞计数可能是低度非霍奇金淋巴瘤预后的有用客观指标。
