15例血管免疫母T细胞性淋巴瘤临床病理分析

Clinicopathological characteristics of 15 patients with angioimmunoblastic T-cell lymphoma

目的:探讨血管免疫母T细胞性淋巴瘤(angioimmunoblastic T-cell lymphoma,AITL)的病理、临床特点和CHOP方案的近期疗效。方法:同时采用常规组织病理学、免疫组织化学、细胞遗传学对15例淋巴瘤患者淋巴结的手术活检标本进行研究,并以CHOP方案作为初始治疗,复发后以MINE+P方案解救。结果:15例患者均表达T细胞抗原CD45RB、CD3和CD45RO,10例(10/15)表达CD10,10例(10/15)表达CD21,4例(4/14)染色体异常。全组15例均能评价疗效,15例CHOP方案初治有效率100%均有效,(CR 7例,PR 8例)。复发8例,MINE+P方案解救有效6例(CR 3例,PR 3例),有效率75%。毒副反应以粒细胞计数下降和血小板下降为常见,但均可耐受。结论:常规组织学、免疫组化检查、细胞遗传学是确诊AITL的重要手段,CHOP方案初治有效率高,但易复发,MINE+P方案解救有效率较高,毒副反应可以耐受。

Objective：To study the clinical and pathological characteristics of the patients with angioimmunoblastic T-cell lymphoma and the short-term effects of CHOP regimen. Methods： The histological, immunohistochemical, and cytogenetic examination were performed on the biopsy specimens of superficial lymph nodes from 15 patients with angioimmunoblastic T-cell lymphoma. All of the patients received the CHOP regimen as the first-line chemotherapy and MINE＋P regimen as the secondline chemotherapy after relapse. Results：T cell antigen CD45RB, CD3, and CD45RO were expressed in superficial lymph nodes of all the 15 patients. Expression of CD10 was detected in 10 out of 15 patients （66.7%）and CD21 expression was also detected in 66.7% patients （10/15）. Four patients（4/14, 26.7%）showed chromosomal abnormality. All the 15 patients were evaluable. The response rate to CHOP regimen as the first line chemotherapy is 100 % （7 cases achieved complete response and 8 cases had partial response）. Six patlens had the response to MINE＋P salvage regimen （3 cases had CR and 3 cases had PR）. The main toxicities including neutropenia and thrombocytopenia were tolerable. Conclusion： Routine histological, immunohistochemical, cytogenetic examinations play significant roles in final diagnosis of angioimmunoblastic T-cell lymphoma. The first-line CHOP regimen has high efficacy but tumor is easy to relapse. The MINE＋P regimen is an effective salvage regimen with tolerable toxicities.