60例HIV阴性浆母细胞淋巴瘤患者的临床特征及预后

Clinical Features and Prognosis of 60 Cases of HIV-negative Plasmablastic Lymphomas Patients

目的探讨HIV阴性浆母细胞淋巴瘤(PBL)的临床特征及预后。方法搜集1997年1月1日—2020年3月30日本院及其他文献报道的HIV阴性PBL病例,使用Logistic回归分析、Kaplan-Meier法和Cox回归分析对筛选的临床特征、分子病理、治疗以及预后相对完整的病案进行分析。结果共收集60例患者,平均年龄为53.06±14.36岁,多数患者有较高的Ann Arbor分期和Ki-67表达,OS为13.48±13.21月,Kaplan-Meier分析显示Ann Arbor分期、IPI指数(3~5)、B症状、初始治疗能否达到CR均与生存显著相关。Cox回归分析显示Ann Arbor分期和IPI指数是影响患者生存的独立预后因素。结论HIV阴性浆母细胞淋巴瘤发病多在中老年段,诊断时分期偏晚,肿瘤增殖较快,治疗以联合化疗为主,但治疗反应和OS的异质性较大,多数预后不良,疾病分期和IPI指数与预后显著相关。

Objective To investigate the clinical features and prognosis of HIV-negative plasmablastic lymphoma(PBL)patients.Methods We collected HIV-negative PBL cases reported in our hospital and other literatures from online databases from January 1,1997 to March 30,2020.The data of clinical features,molecular pathology,treatment and prognosis were summarized and analyzed.Results We included 60 PBL patients,average age was 53.06±14.36 years,and most of them had relatively high Ann Arbor stage and Ki-67 expression.The average OS was 13.48±13.21 m.Kaplan-Meier curve revealed Ann Arbor stage,IPI index(3-5),B symptoms and CR in initial treatment were significantly related with patients’survival.Cox regression analysis indicated that the Ann Arbor stage and IPI index were the independent prognostic factors for patients’survival.Conclusion HIV-negative PBL mostly occurs in the middle-age and elderly patients,with advanced diagnosis stage and rapid tumor proliferation.Combination chemotherapy is the main treatment,while the therapeutic response and OS might be heterogeneous,the prognosis of most patients would be poor.The stage and IPI index are significantly related to the prognosis.