血管免疫母细胞性淋巴结病（AILD）型T细胞淋巴瘤：初诊时临床观察和实验室检查结果对预后的影响。基尔淋巴瘤研究组

Angioimmunoblastic lymphadenopathy (AILD)-type T-cell lymphoma: prognostic impact of clinical observations and laboratory findings at presentation. The Kiel Lymphoma Study Group.

作者信息

Siegert W, Nerl C, Agthe A, Engelhard M, Brittinger G, Tiemann M, Lennert K, Huhn D

机构信息

Universitätsklinikum Rudolf Virchow, Abteilung für Innere Medizin mit Schwerpunkt Hämatologie und Onkologie, Freie Universität Berlin, Germany.

出版信息

Ann Oncol. 1995 Sep;6(7):659-64. doi: 10.1093/oxfordjournals.annonc.a059281.

DOI:10.1093/oxfordjournals.annonc.a059281

PMID:8664186

Abstract

BACKGROUND

In order to establish the clinico-pathological properties of angioimmunoblastic lymphadenopathy (AILD)-type T-cell lymphoma, we evaluated the type, incidence and prognostic significance of clinical and laboratory symptoms.

PATIENTS AND METHODS

Sixty-two consecutive patients diagnosed at the Kiel lymph node registry participated in the study. The median patient age was 64 years (range 21-87 years) and the female to male ratio was 1:1.4. Ninety percent of the patients were in stage III and IV and B-symptoms were observed in 68%. At diagnosis patients presented with skin rash (49%), pruritus (32%), edema (38%), pleural effusion (37%), arthritis (18%) and ascites (23%). Furthermore, they exhibited autoimmune phenomena such as cold agglutinines, circulating immune complexes, a positive Coombs test, smooth muscle antibodies, rheumatoid factors, immune hemolysis, a paraprotein, antinuclear antibodies and cryoglobulins.

RESULTS

In univariate analysis, survival was significantly related to age (p=0.032), stage (p=0.037), B symptoms (p=0.007), rash/pruritus (p=0.038), edema (p=0.030), ascites (p=0.013), number of clinical symptoms including B symptoms (p=0.004) and excluding B symptoms (p=0.017), lactate dehydrogenase (p=0.007) and hemoglobin (p=0.020).

CONCLUSIONS

AILD type T-cell lymphoma characteristically differs from other non-Hodgkin's lymphomas in its clinical signs and laboratory symptoms.

摘要

背景

为了确定血管免疫母细胞性淋巴结病（AILD）型T细胞淋巴瘤的临床病理特征，我们评估了临床和实验室症状的类型、发生率及预后意义。

患者与方法

62例在基尔淋巴结登记处确诊的连续患者参与了本研究。患者的中位年龄为64岁（范围21 - 87岁），男女比例为1:1.4。90%的患者处于III期和IV期，68%的患者有B症状。诊断时患者出现皮疹（49%）、瘙痒（32%）、水肿（38%）、胸腔积液（37%）、关节炎（18%）和腹水（23%）。此外，他们还表现出自身免疫现象，如冷凝集素、循环免疫复合物、库姆斯试验阳性、平滑肌抗体、类风湿因子、免疫性溶血、副蛋白、抗核抗体和冷球蛋白。

结果

单因素分析显示，生存与年龄（p = 0.032）、分期（p = 0.037）、B症状（p = 0.007）、皮疹/瘙痒（p = 0.038）、水肿（p = 0.030）、腹水（p = 0.013）、包括B症状在内的临床症状数量（p = 0.004）以及不包括B症状的临床症状数量（p = 0.017）、乳酸脱氢酶（p = 0.007）和血红蛋白（p = 0.020）显著相关。