儿童非霍奇金淋巴瘤临床特点及疗效

Various clincal appearances and therapeutic efficacy of childhood non-Hodgkin's lymphoma

目的 :分析儿童非霍奇金淋巴瘤 (NHL)早期临床症状的多样性及远期临床疗效。方法 :35例NHL中 12例为Ⅲ期NHL ,2 3例为Ⅳ期NHL。初发病例 2 7例 ,复发 8例。Ⅳ期和Ⅲ期NHL(T细胞型 )患者予MCP 841方案 ,Ⅲ期B组细胞型患者予MCP 842方案。化疗前后采用综合措施防治各种并发症。结果 :所有病例经MCP 841和MCP 842方案序贯化疗后持续完全缓解 (CCR) 2 4例 (6 8.6 % )。CCR >5年 10例 ,CCR中位时间 2 9个月。序贯方案中的强化疗方案应用后骨髓抑制明显 ,但无感染相关死亡 ,无严重出血 ,无明显肝、肾和心脏等重要脏器损伤。结论 :儿童NHL早期临床表现具多样性且不典型 ,容易误诊 ,必须予以足够重视。确诊病例经MCP 841和MCP 842方案序贯治疗后 ,临床疗效较好 ,毒副反应小且较易恢复 。

Objective:To study the diversity of clinical characteristics and the long-term outcome of children with advanced non-Hodgkin's lymphoma (NHL).Method:Among 35 patients,23 cases were of stage Ⅳ and 12 cases of stage Ⅲ.All of the cases were treated with protocol of MCP-841 or MCP-842 respectively.The synthetic prophylaxis for complication was applied for all patients during and after the chemotherapy.Result:The time from the original symptom to the confirmed diagnose was ranged from half a month to 10 months.Up to now,there are 24 cases ( 68.7%) in the state of continuous complete remission (CCR).The median of duration for CCR was 29 months.No patient died of intensive chemotherapy and serious complication.Conclusion:The various features of childhood NHL may lead to the wrong diagnose.Protocol of MCP-841 and MCP-842 were effective and less toxicity to this malignancy.