慢性淋巴细胞白血病/小淋巴细胞淋巴瘤合并非霍奇金淋巴瘤临床分析

Clinical Analysis of Chronic Lymphocytic Leukemia Complicated with Non-Hodgkin's Lymphoma

目的增加对慢性淋巴细胞白血病合并非霍奇金淋巴瘤临床病例的认识。方法通过报道2011年11月和2012年7月入住的2例确诊为慢性淋巴细胞白血病合并非霍奇金淋巴瘤患者的诊治过程,复习文献,讨论其发病机制、治疗及预后。结果该2例患者均予以化疗,其中1例浅表淋巴结明显缩小,骨髓涂片基本恢复正常,病情控制较好;另1例合并症多、病情恶化快、肿瘤化疗效果欠佳,最后因呼吸衰竭死亡。结论慢性淋巴细胞白血病合并非霍奇金淋巴瘤,治疗上应综合考虑患者年龄、ECOG评分、临床分期、预后指数等因素,原则上以治疗恶性程度更高的非霍奇金淋巴瘤为主,可根据慢性淋巴细胞白血病分期进行观察、随访或积极治疗。

Objective To raise the awareness of chronic lymphocytic leukemia complicated with non-hodgkin＇s lymphoma.Methods By reporting the diagnosis and treatment process of two cases of chronic lymphocytic leukemia complicated with non-Hodgkin＇s lymphoma diagnosed in November,2011 and July,2012,we reviewed literature,and discussed its pathogenesis,treatment and prognosis.Results The two patients in our hospital both received chemotherapy.One had the superficial lymph nodes significantly narrowed,normal bone marrow smear results,and good disease control,while the other one had more complications,faster deterioration of condition,and inefficiency of chemotherapy,and finally died of respiratory failure.Conclusions In terms of patients with chronic lymphocytic leukemia complicated with non-Hodgkin＇s lymphoma,their age,ECOG score,clinical stages and prognosis index should be comprehensively considered in the choice of treatment plan.In principle,treatment should give priority to non-Hodgkin＇s lymphoma with higher malignant degree,while chronic lymphocytic leukemia,according to its stage,can be observed,followed up or treated actively.