48例血管免疫母性T细胞淋巴瘤治疗及预后因素分析

Treatment response and prognosis factors in 48 patients with angioimmunoblastic T cell lymphoma

目的：探讨影响血管免疫母性T细胞淋巴瘤（AITL）疗效和预后的因素。方法收集48例AITL患者的临床资料，评价其疗效，探讨影响其预后的因素。结果48例AITL患者，完全缓解（CR）15例，部分缓解（PR）16例，总有效率为64.58%（31/48）。国际预后指数（IPI）评分≤2分患者的近期总有效率明显优于IPI评分＞2分患者[84.00%（21/25）比43.48%（10/23）]，差异有统计学意义（P＜0.05）。1、2、3年总生存率分别为75.00%（36/48）、52.08%（25/48）及35.42%（17/48），中位生存时间24.5个月。Ann Arbor分期Ⅰ～Ⅱ期、IPI评分≤2分、Ki-67＜50%及应用CHOP联合门冬酰胺酶方案化疗患者较Ann Arbor分期Ⅲ～Ⅳ期、IPI评分＞2分、Ki-67≥50%及应用 CHOP 方案化疗患者的3年生存率高[8/13比25.71%（9/35）、52.00%（13/25）比17.39%（4/23）、55.00%（11/20）比21.43%（6/28）、48.28%（14/29）比3/19]，差异有统计学意义（P＜0.05）。结论 AITL是一类预后不良的疾病，IPI评分是影响近期疗效的重要因素。患者的Ann Arbor分期、IPI评分、Ki-67水平及应用包含门冬酰胺酶方案的化疗是影响患者预后的重要因素。

Objective To explore the influencing factors of therapeutic effect and prognosis in patients with angioimmunoblastic T cell lymphoma （AITL）. Methods The clinical data of 48 patients with AITL were collected in order to evaluate its therapeutic effect and the influencing factors of prognosis. Results In the 48 patients with AITL, complete remission （CR） was in 15 cases, partial remission （PR） was in 16 cases, and the total effective rate was 64.58%（31/48）. The recent total effective rate in patients of international prognostic index （IPI） score ≤2 scores was significantly higher than that in patients of IPI score 〉2 scores： 84.00% （21/25） vs. 43.48% （10/23）, and there was statistical difference （P〈0.05）. The 1-year, 2-year and 3-year overall survival rates were 75.00%（36/48）, 52.08%（25/48） and 35.42%（17/48）, and the median survival time was 24.5 months. The patients of Ann Arbor stage Ⅰ-Ⅱ, IPI score ≤ 2 scores, Ki-67〈50% and using CHOP combined with asparaginase （ASP） regimen had a higher 3-year overall survival rate compared with the patients of Ann Arbor stage Ann Arbor stage Ⅲ -Ⅳ, IPI score 〉2 scores, Ki-67 ≥ 50% and using CHOP regimen： 8/13 vs. 25.71%（9/35）, 52.00% （13/25） vs. 17.39% （4/23）, 55.00% （11/20） vs. 21.43% （6/28） and 48.28% （14/29） vs. 3/19, and there were statistical differences （P〈0.05）. Conclusions AITL is a kind of disease with poor prognosis. IPI score is the important influencing factor of recent therapeutic effect. The Ann Arbor stage, IPI score, Ki-67 levels and using contained ASP chemotherapy are the important factors of prognosis in patients with AITL.