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目的:探讨初治、年轻、中高/高危弥漫大B细胞淋巴瘤(diffuse large B cell lymphoma,DLBCL)的临床特征、治疗措施及预后影响因素。方法:回顾性分析2006年1月至2014年5月军事医学科学院附属医院淋巴瘤科收治的年龄≤60岁、年龄调整的国际预后指数(aa IPI)评分≥2分的初治DLBCL病例,进行疗效及预后相关因素的分析。结果:共收集到资料完整的DLBCL病例120例,中位随访28(4-106)个月,3年PFS率53.25%,OS率61.52%。单因素分析结果显示B症状、治疗方案及近期疗效、自体移植对无进展生存(PFS)及总体生存(OS)率的影响有统计学意义。多因素分析结果显示治疗方案、自体造血干细胞移植是影响PFS、OS率的独立影响因素。结论:年轻、中高/高危DLBCL具有高度异质性,病理细胞来源、Ki-67等在本组病例中未见显著预后意义,有待临床进一步探索。
Objective: To investigate the clinical features, treatment and prognostic factors of newly diagnosed, young, moderate-high / high-risk diffuse large B cell lymphoma (DLBCL). Methods: A retrospective analysis of untreated DLBCL cases aged ≤60 years and age adjusted International Prognostic Index (aa IPI) score ≥2 points was performed from January 2006 to May 2014 at the Lymphoma Department of the Academy of Military Medical Sciences Efficacy and Prognosis Related Factors. Results: A total of 120 DLBCL cases were collected. The median follow-up was 28 (4-106) months. The 3-year PFS rate was 53.25% and the OS rate was 61.52%. Univariate analysis showed that the symptoms of B, treatment options and short-term efficacy, autologous transplantation on progression-free survival (PFS) and overall survival (OS) rate was statistically significant. Multivariate analysis showed that treatment regimen and autologous hematopoietic stem cell transplantation were independent influencing factors of PFS and OS rates. CONCLUSION: The young, high-risk / high-risk DLBCL have high heterogeneity, pathological cells, Ki-67 and so no significant prognostic significance in this group of cases, pending further clinical exploration.