恶性淋巴瘤贫血发生率调查分析

Investigation and analysis of anemia incidence in lymphoma patients

目的：研究恶性淋巴瘤患者的贫血发生情况及其影响因素。方法：对我院2007—05-04—2012-09—30住院的1474例恶性淋巴瘤患者（初治1145例，复治329例）进行回顾性分析，统计其贫血发生率，并根据初治或复治、不同．病理类型、性别、年龄、临床分期或是否有B症状进行分组分析。结果：初治患者的贫血发生率为23．3％（267／1145），复治患者的贫血发生率为41．9％（138／329），明显升高，χ2=44．5，P〈0．001。不同病理类型初治患者贫血发生率由高至低依次为淋巴浆细胞淋巴瘤75．0％，血管免疫母T细胞淋巴瘤40．0％，套细胞淋巴瘤32．6％，外周T细胞淋巴瘤（非特指型）29．4％，弥漫大B细胞淋巴瘤25．3％，霍奇金淋巴瘤24．8％，边缘区B细胞淋巴瘤24．7％，NK／T细胞淋巴瘤21．4％，Burkitt淋巴瘤16．7％，问变大T细胞淋巴瘤14．3％，淋巴母细胞淋巴瘤11．3％，滤泡性淋巴瘤10．7％，蕈样霉菌病10％，弥漫小B细胞淋巴瘤8．3％。单因素分析发现，病理类型（χ2=32．4，P=0．002）、年龄（χ2=8．0，P=0．005）、分期（χ2=60．7，P〈0．001）和B症状（χ2=127．8，P〈0．001）是初治淋巴瘤贫血的危险因素。初治的贫血患者中侵犯食管、胃和肠等部位的患者比例较高，为35．2％（94／267）。结论：恶性淋巴瘤患者有较高的贫血发生率，复治患者贫血发生率明显高于初治患者，初治患者贫血的发生与病理类型、年龄、分期和B症状有密切关系。年龄〉60岁、Ⅲ～Ⅳ期、胃肠道侵犯、有B症状患者更易发生贫血。

OBJECTIVE .. To study the incidence and risk factors of anemia in patients with lymphoma. METHODS： Retro- spective analysis was conducted in 1 474 patients from May 4th,2007 to Sep. 30th,2012 ,including 1 145 patients with previously untreated lymphoma and 329 patients with previously treated lymphoma. The frequency of anemia was evaluated, and the correla- tion between anemia and histologic subtype, sex, age, clinical stage and B symptom were analysed. RESULTS.. The anemia inci- dences were 23.3% （267/1 145） and 41.9% （138/329） respectively in previously untreated and treated patients （χ2=44. 5 ,P〈0.001）. The anemia incidence was 75.00% for lymphoplasmacytoid lymphoma, 40.0 % for angioimmunoblastic T-cell lymphoma, 32.6% for mantle cell lymphoma,29.4% for peripheral T-cell lymphoma （unspecified）, 25.3% for diffuse large B-cell lymphona,24.8% for Hodgkin lymphoma,24. 7% for marginal zone lymphoma, 21.4% for NK/T-cell lymphoma, 16.7% for Burkitt lyrnphoma, 14.3 % for anaplastic large cell lymphoma, 11.3 % for lymphoblastic lymphoma, 10.7 % for follicular lymphoma, 10 % for mycosis fungoides, 8. 3 % for small lymphocytic lymphoma. Univariate analysis showed that anemia had significantly associated with histologic subtypes, age, clinical stage and B symptoms （χ2=32.4, P = 0. 002 ; 2 = 8.0, P = 0. 005 ; χ2=60. 7, P=0. 001 χ2= 127. 8, P%0. 001）. The proportion of gastro-intestinal involvement was high 35.2 % （94/267） in previous untreated patients with anemia. CONCLUSIONS： Anemia is common in patients with lymphoma. The anemia incidence is significantly higher in previ- ously treated patients than that in untreated patients. Anemia is more likely to occur in the patients with older, stage Ⅲ and Ⅳ, gastro-intestinal involvement and B symptoms.