老年淋巴瘤临床特征与预后相关因素分析

Analysis of clinical features and prognostic factors of elderly lymphoma

目的本研究旨在讨论老年淋巴瘤患者(年龄≥ 60岁)的临床特征与预后相关因素。方法收集2010年1月-2016年12月复旦大学附属华东医院血液科收治的162例老年(年龄≥ 60岁)淋巴瘤患者数据进行分析。结果 162例患者中44%年龄超过70岁,84%患者疾病诊断时处于Ⅲ~Ⅳ期,62%患者表现出B症状,患者总中位生存时间为76个月,5年的总体生存率(OS)为62.3%。霍奇金淋巴瘤、侵袭性非霍奇金淋巴瘤、惰性非霍奇金淋巴瘤、B细胞淋巴瘤(未分类)、T细胞淋巴瘤(未分类)的患者中位总生存期分别为55个月、未达到、76个月、10个月和10个月。采用COX回归模型进行多因素分析结果显示,国际预后指数(IPI评分)≥3分(P=0.001)、血浆白蛋白水平<30 g/L(P=0.003)、碱性磷酸酶水平>126 U/L (P=0.007)均为独立影响因素,三者的相对危险度(HR)分别为:2.966;4.704;3.399。结论 IPI评分≥ 3分、血浆白蛋白<30 g/L、碱性磷酸酶水平>126 U/L可能为老年非霍奇金淋巴瘤患者预后的不利因素。

Objective The purpose of this paper is to investigate the clinical features and prognosis of the elderly patients with lymphoma(≥ 60 years old).Methods To collect relevant factors of 162 cases of elderly(≥ 60 years old) lymphoma patient from January 2010 to December 2016,in the Department of Hematology,Huadong Hospital Affiliated to Fudan Uinverstiy,Data were analyzed.Results Of 162 patients,44% were over 70 years of age,84% were in stage III to IV at the time of diagnosis,and 62% showed symptoms B,the median survival time were 76 months,The 5-year overall survival(OS)were 62.3%.Median overall survival was 55 months for Hodgkin’s lymphoma,unreached for invasive non-Hodgkin’s lymphoma,76 months forindolent non-Hodgkin’s lymphoma,10 months for B-cell lymphoma(unclassified),and 10 monthsfor T-cell lymphoma(unclassified),respectively.Multivariate analysis show that IPI score≥3分(P=0.001),plasma albumin levels<30 g/L(P=0.003),alkaline phosphatase levels> 126 U/L(P=0.007) are independent prognostic factors,The relative risk(HR) of the three were 2.966;4.704;3.399.Conclusion IPI score≥ 3,plasma albumin level<30 μg/L and alkaline phosphatase level> 126 U/L are adverse factors for the prognosis of elderly patients with non-Hodgkin’s lymphoma.