外周T细胞淋巴瘤26例疗效及预后因素分析

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目的研究外周T细胞淋巴瘤(peripheral T-cell lymphoma,PTCL)的疗效和预后因素。方法回顾性分析2010年1月至2013年12月中国医科大学附属盛京医院诊治的26例PTCL患者的临床资料,探讨与疗效及预后相关的因素。结果经治疗后,2例(7.7%)完全缓解(CR),8例(30.8%)部分缓解(PR),7例(26.9%)疾病稳定(SD),9例(34.6%)疾病进展(PD),总有效率(CR+PR,ORR)为38.5%。患者的骨髓受累和CA125升高同患者的近期疗效相关。截至随访日期,死亡17例。中位生存时间为28个月,1年、2年、3年的生存率分别为69.2%、56.7%、41.4%。单因素分析显示,Ann Arbor分期、国际预后指数(IPI)评分、骨髓侵犯、美国东部肿瘤协作组(ECOG)评分、CA125水平、血红蛋白(Hb)<110 g/L、血小板计数(PLT)<135×109/L、白蛋白<35 g/L、治疗后ORR与生存率相关(均P<0.05)。多因素分析显示,骨髓侵犯(HR 0.007)、ECOG(HR 0.004)、ORR(HR 0.020)是PTCL患者独立预后因素。结论 PTCL患者预后差,ORR低,骨髓受累和CA125升高同患者的近期疗效相关,Ann Arbor分期、IPI评分、骨髓侵犯、ECOG评分、CA125水平、Hb<110 g/L、PLT<135×109/L、白蛋白<35 g/L、治疗后ORR与生存率相关,骨髓侵犯、ECOG、ORR是PTCL患者独立预后因素。 Objective To study the efficacy and prognosis of peripheral T-cell lymphoma (PTCL). Methods The clinical data of 26 patients with PTCL diagnosed and treated by Shengjing Hospital affiliated to China Medical University from January 2010 to December 2013 were retrospectively analyzed to explore the factors related to the efficacy and prognosis. Results After treatment, 2 patients (7.7%) achieved complete remission (CR), 8 patients (30.8%) were partially relieved (PR), 7 patients (26.9%) had stable disease (SD) and 9 patients (34.6% PD), the total effective rate (CR + PR, ORR) was 38.5%. Bone marrow involvement and elevated CA125 are associated with the patient’s immediate effect. As of the follow-up date, 17 died. The median survival time was 28 months. The 1-year, 2-year and 3-year survival rates were 69.2%, 56.7% and 41.4% respectively. Univariate analysis showed that Ann Arbor staging, International Prognostic Index (IPI) score, bone marrow invasion, ECOG score, CA125 level, hemoglobin (Hb) <110 g / L and platelet count (PLT) × 109 / L, albumin <35 g / L, after treatment ORR and survival were related (all P <0.05). Multivariate analysis showed that bone marrow invasion (HR 0.007), ECOG (HR 0.004), and ORR (HR 0.020) were independent predictors of PTCL. Conclusion The poor prognosis, low ORR, low bone marrow involvement and elevated CA125 in patients with PTCL are related to the short-term outcomes of the patients. Ann Arbor staging, IPI score, bone marrow invasion, ECOG score, CA125 level, Hb <110 g / L, PLT <135 × 109 / L, albumin <35 g / L, after treatment ORR and survival, bone marrow invasion, ECOG, ORR is an independent prognostic factor in patients with PTCL.
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