Pittaluga S, Verhoef G, Criel A, Maes A, Nuyts J, Boogaerts M, De Wolf Peeters C
Department of Pathology, Belgium.
Leuk Lymphoma. 1996 Mar;21(1-2):115-25. doi: 10.3109/10428199609067588.
Bone marrow trephine and peripheral blood smears taken at diagnosis of 55 cases of well-documented mantle cell lymphomas were reviewed in order to analyse the leukaemic involvement in this non-Hodgkin's lymphoma: its incidence, morphological characteristics and prognostic significance. A median survival of 36 months was found. The median age was 61 and the male to female ratio was 4:1. Morphologically 7 cases presented with a mantle zone pattern, all the others had a diffuse pattern. Involvement of the bone marrow was found in 58% and a trend for prolonged survival in patients with a negative trephine was seen. An absolute lymphocytosis above 10,000 mu l was found at diagnosis in 5 cases (10%) and had a statistically significant impact on survival. An additional 5 cases developed frank leukaemia during the course of the disease and died within 1 to 6 months of this evolution, suggesting that marked lymphocytosis is more a terminal event associated with an extremely poor prognosis than a presenting symptom. Finally we identified an additional parameter with statistically prognostic significance, namely, the presence of atypical cells in the peripheral blood even in the absence of an increased lymphocytosis.
回顾了55例确诊为有充分记录的套细胞淋巴瘤患者诊断时所取的骨髓活检组织切片和外周血涂片，以分析这种非霍奇金淋巴瘤的白血病浸润情况：其发生率、形态学特征及预后意义。发现中位生存期为36个月。中位年龄为61岁，男女比例为4:1。形态学上，7例呈现套区模式，其余均为弥漫性模式。58%的患者存在骨髓浸润，且骨髓活检阴性的患者有生存期延长的趋势。5例（10%）患者在诊断时外周血绝对淋巴细胞计数高于10,000/μl，这对生存期有统计学显著影响。另外5例在疾病过程中发展为明显白血病，并在病情进展的1至6个月内死亡，这表明明显的淋巴细胞增多更多是与极差预后相关的终末期事件，而非首发症状。最后，我们确定了另一个具有统计学预后意义的参数，即在无淋巴细胞增多增加的情况下外周血中存在非典型细胞。
