外周T细胞淋巴瘤26例疗效及预后因素分析

Analysis of treatment response and prognosis factors of for peripheral T-cell lymphoma

目的研究外周T细胞淋巴瘤(peripheral T-cell lymphoma,PTCL)的疗效和预后因素。方法回顾性分析2010年1月至2013年12月中国医科大学附属盛京医院诊治的26例PTCL患者的临床资料,探讨与疗效及预后相关的因素。结果经治疗后,2例(7.7%)完全缓解(CR),8例(30.8%)部分缓解(PR),7例(26.9%)疾病稳定(SD),9例(34.6%)疾病进展(PD),总有效率(CR+PR,ORR)为38.5%。患者的骨髓受累和CA125升高同患者的近期疗效相关。截至随访日期,死亡17例。中位生存时间为28个月,1年、2年、3年的生存率分别为69.2%、56.7%、41.4%。单因素分析显示,Ann Arbor分期、国际预后指数(IPI)评分、骨髓侵犯、美国东部肿瘤协作组(ECOG)评分、CA125水平、血红蛋白(Hb)<110 g/L、血小板计数(PLT)<135×109/L、白蛋白<35 g/L、治疗后ORR与生存率相关(均P<0.05)。多因素分析显示,骨髓侵犯(HR 0.007)、ECOG(HR 0.004)、ORR(HR 0.020)是PTCL患者独立预后因素。结论 PTCL患者预后差,ORR低,骨髓受累和CA125升高同患者的近期疗效相关,Ann Arbor分期、IPI评分、骨髓侵犯、ECOG评分、CA125水平、Hb<110 g/L、PLT<135×109/L、白蛋白<35 g/L、治疗后ORR与生存率相关,骨髓侵犯、ECOG、ORR是PTCL患者独立预后因素。

Objective To investigate the treatment response and prognostic factors of peripheral T cell lymphoma. Methods Clinical data of 26 cases of PTCL in our hospital from January 2010 to December 2013 were retrospectively analyzed with the treatment response and prognostic factors evaluated. Results Of all the patients, complete remission （CR） rate was 7.7% （2/26）, partial remission （PR） rate was 30.8% （8/26）, stabal disease（SD） was 26.9%（7/26）, progressive disease（PD） rate was 34.6%（9/26）, and overall response rate （ORR） was 38.5%. Patients with bone marrow infiltration （ Fisher P=0.035） and higher CA125（Pisher P=0.023） have worse recent curative effect compared with patients without. To the date of follow-up, seventeen patients died and nine patients survived.Median survival time was 28 months. The 1-year, 2-year and 3-year overall survival rates were 69.2%, 56.7% and 41.4% respectively. Univariate analysis showed that Ann Arbor stage（P=0.038）, IPI scores（P=0.021）, bone marrow infiltration（P=0.01）, ECOG scores（P=0.00）, CA125（P=0.006）, Hb〈 110 g/L（P=0.021）, PLT〈 135×10^9/L（P=0.015）, albumin〈35 g/L（P=0.003）, treatment response to get ORR （P=0.001） were associated with overall survival rate （P〈0.05）. Multivariate analysis showed bone marrow infiltration（HR 0.007）, ECOG scores（HR 0.004）, treatment response to get ORR（HR 0.020） were the independent prognostic factors of PTCL. Conclusion PTCL is one of the diseases with poor prognosis and low OR. Bone marrow infiltration and higher CA125 are associated with short-term effects. Ann Arbor stage, IPI scores, bone marrow infiltration, ECOG scores, CA125, lib〈 110 g/L, PLT〈 135×10^9/L, Albumin〈35 g/L, and treatment response to get ORR are related with overall survival rate. Bone marrow infrltration, ECOG scores, and treatment response to get ORR are the independent prognostic factors of PTCL.