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目的:探讨套细胞淋巴瘤(MCL)的临床特征、治疗效果及预后影响因素。方法:回顾性分析我科21例MCL患者的临床资料,分别比较CHOP方案与RCHOP方案以及联合沙利度胺治疗MCL患者的总有效率(ORR)、无进展生存时间(PFS)、总生存期(OS),分析患者年龄、性别、ECOG评分、肿瘤分期、国际预后指数(IPI)评分、B症状、白细胞计数、乳酸脱氢酶(LDH)、骨髓受侵等对预后的影响。结果:21例MCL患者治疗后ORR为81%(17/21),CHOP类方案治疗组ORR为71%(10/14),RCHOP类方案治疗组ORR为100%(6/6),3年OS率、PFS率分别为34%、13%与63%、33%,两组的ORR、OS、PFS率差异无统计学意义(P>0.05);联合沙利度胺组与常规治疗组的ORR、OS、PFS率分别为71%(5/7)、64%、43%与86%(12/14)、23%、11%,但两组差异无统计学意义(P>0.05)。分期晚、骨髓受侵、LDH增高、白细胞增高的患者预后更差,差异有统计学意义(P<0.05),年龄、性别、IPI评分、B症状、ECOG评分对治疗效果及OS的影响差异无统计学意义(P>0.05)。结论:MCL多为老年男性,分期晚,以CHOP方案化疗为基础的治疗仍是主要的治疗方式,虽治疗有效率较高,但治愈率低,联合沙利度胺辅助治疗有望提高疗效、延长生存期,分期晚、骨髓受侵、LDH增高、白细胞增高是预后不良因素。
Objective: To investigate the clinical characteristics, therapeutic effect and prognostic factors of mantle cell lymphoma (MCL). Methods: The clinical data of 21 patients with MCL in our department were retrospectively analyzed. The total effective rate (ORR), progression-free survival time (PFS), overall survival of patients with MCL combined with CHOP regimen and RCHOP regimen and with thalidomide combined with thalidomide were compared. (OS). The prognosis of patients with age, sex, ECOG score, tumor staging, International Prognostic Index (IPI) score, B symptom, leukocyte count, lactate dehydrogenase (LDH) RESULTS: The ORR was 81% (17/21) in 21 MCL patients, ORR was 71% (10/14) in the CHOP regimen, ORR was 100% (6/6) in the RCHOP regimen, and 3 years OS rates and PFS rates were 34%, 13%, 63% and 33% respectively. There was no significant difference in ORR, OS and PFS between the two groups (P> 0.05). The combination of thalidomide and conventional treatment ORR, OS, PFS rates were 71% (5/7), 64%, 43% and 86% (12/14), 23% and 11% respectively. There was no significant difference between the two groups (P> 0.05). Patients with late stage, bone marrow invasion, LDH increased, leukocytosis patients had worse prognosis, the difference was statistically significant (P <0.05), age, sex, IPI score, B symptoms, ECOG score on the treatment effect and OS Statistical significance (P> 0.05). Conclusion: MCL is mostly elderly men with late stage, the treatment based on CHOP regimen is still the main treatment, although the treatment is effective, but the cure rate is low. Combined with thalidomide adjuvant therapy is expected to improve the efficacy and prolongation Survival, late stage, bone marrow invasion, increased LDH, leukocytosis is an adverse prognostic factor.