恶性淋巴瘤并发白血病33例临床分析

The clinical analysis of 33 cases of malignantlymphoma complicated with leukemia

目的:探讨恶性淋巴瘤并发白血病的并发率、疗效及预后。方法:收集1983年4月至1997年10月经病理及骨髓检查确诊的淋巴瘤并发白血病33例,其中非霍奇金淋巴瘤(NHL)32例,霍奇金病(HD)1例。采用化疗或局部联合60钴放疗。结果:总有效率为33.3%,其中CR12.1%、PR21.2%。1年生存率为45%,其中高、中、低度NHL并发白血病的1年生存率分别为26.7%、50%、85.7%,中位生存期10个月。结论:并发白血病者全组为16.2%,NHL为21.6%,HD为1.78%;高度恶性,年龄小于30岁,B症状,脾肿大,末梢血白细胞数大于10×109/L等因素与易并发白血病有关。恶性淋巴瘤并发白血病者预后差。

Objective:To study the incidence,therapeutic effect and prognosis of malignant lymphoma with leukemia.Methods:From Apr.1983 to Oct.1997,33 cases of lymphoma complicated with leukemia were diagnosed by pathological and bone marrow examination.Among them 32 cases were Non Hodgkin's lymphoma(NHL) and 1 case was Hodgkin's Disease (HD).The treatments were chemotherapy alone or combined with local irradiation of cobalt -60.Results:The overall response rate was 33.3%,with CR 12.1% and PR 21.2%.The 1 year survival rate was 45%.And 1 year survival rate for high,intermediate and low grade NHL with leukemia were 26.7%,50% and 85.7%,respectively.The median survival period was 10 months.Conclusion:The incidence of leukemia for the whole group was 16.2%,21.6% in NHL and 1.78% in HD.The predisposed factors were high grade,age <30 ys,B symptom,splenomegaly and WBC >10×10 9/L in peripheral blood.The prognosis was poor.