CHOP或CHOP样方案一线治疗晚期血管免疫母细胞型T细胞淋巴瘤效果观察

Therapeutic efficacy of first-line CHOP or CHOP-like chemotherapy on patients with advanced staged angioimmunoblastic T-cell lymphoma

目的 分析CHOP或CHOP样方案一线治疗血管免疫母细胞型T细胞淋巴瘤（AITL）的效果.方法 回顾性分析2006年8月至2014年2月收治的29例应用CHOP或CHOP样方案一线治疗的晚期AITL患者的临床资料,总结其临床特征,分析疗效及其预后因素.结果 患者中位发病年龄为59岁,全部为Ⅲ～Ⅳ期,17例（58.6％）伴B症状,26例（89.7％）IPI评分≥2分,20例（69.0％）起病时乳酸脱氢酶升高,9例（31.0％）出现≥2个结外器官受侵.中位随访20个月,总有效率为69.0％（20/29）,其中17.2％（5/29）的患者初治达完全缓解或未确定完全缓解,51.7％（15/29）达部分缓解,20.7％（6/29）出现疾病进展,10.3％（3/29）稳定.中位无进展生存（PFS）期为6个月.1、2年PFS率分别为39.0％、20.0％.1、2、5年总生存（OS）率分别为76.8％、53.4％和17.1％.治疗有效患者PFS长于无效患者（P＜ 0.001）,有效与无效患者OS差异无统计学意义（P＞0.05）.结论 CHOP或CHOP样方案一线治疗AITL的总体疗效不满意,有待进一步探索新的治疗方法.

Objective To evaluate the efficacy of first-line CHOP or CHOP-like regimen on patients with advanced staged angioimmunoblastic T-cell lymphoma （AITL）.Methods Between Aug 2006 and Sep 2014,twenty-nine AITL patients who were newly diagnosed without prior treatment were included in study.The clinical features,efficacy and survival were analyzed retrospectively.Results Median age of these patients was 59 years old.All patients had stage Ⅲ/Ⅳ disease.17 （58.6 %） cases presented with B symptoms.26 （89.7 %） cases had an international prognostic index （IPI） score ≥2,and 20 （69.0 %） cases had elevated LDH,9 （31.0 %） cases had ≥2 extranodal involvements.The median follow-up time was 20 months.Overall response rate was 69.0 % （20/29）.Five （17.2 %） patients achieved complete remission （CR＋CRu）,15 （51.7 %） patients achieved partial remission,and 3 （10.3 %） patients had stable disease （SD）,6 （20.7 %） patients had progressive diseases（PD）.Median progression-free survival （PFS） was 6 months.1-and 2-year PFS rates were 39.0 % and 20.0 %.1-,2-and 5-year overall survival （OS） rates for all patients were 76.8 %,53.4 % and 17.1%,respectively.PFS was significantly better in chemotherapy-sensitive patients （P 〈 0.001）.The responses to chemotherapy had a tendency of affecting the OS,but it failed to reach statistical significance （P 〉 0.05）.Conclusions The CHOP or CHOP-like regimen maybe induce unfavorable efficacy in AITL patients.Further therapeutic options are required to improve the outcome.