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儿童非何杰金氏淋巴瘤的临床过程通常进展较快,当纵隔或腹部被广泛波及时,治疗常难取得较长的无病生存,在波及骨髓或中枢神经系统后,患儿几乎均死亡。作者于意大利对29例初治的非何杰金氏淋巴瘤(NHL)患儿进行了联合化疗及局部放疗,并长期随访观察疗效。年龄为1.5～16.5(平均7.5)岁,组织学诊断根据 Kiel 的分类法,其中未分类原始淋巴细胞性10例,原始免疫细胞性2例,回旋细胞型原始淋巴细胞性9例,未作分类3例。此29例中属 Ann Ar-bor 分期Ⅰ、Ⅱ期者8例,Ⅳ期者21例,无Ⅲ期者。患儿一般于住院后48～72 h 内即接受联合化疗。化疗的方案在2个月的诱导期由阿霉素、环磷酰胺、长春新碱及强的松组成。维持期则由六巯嘌呤、氨甲喋呤、阿霉素、长春新碱及强的松组成。若取得完全反应则持续治疗达24个月。10例在诱导期取得早期有效反应后接受了纵隔或腹部等部位的局部放疗。11例作
The clinical course of non-Hodgkin’s lymphoma in children generally progresses rapidly, and when the mediastinum or the abdomen is widely spread, it is often difficult to obtain longer disease-free survival after treatment, with almost all of the infants having been affected by the spread of bone marrow or central nervous system . In Italy, 29 patients with untreated non-Hodgkin’s lymphoma (NHL) underwent combined chemotherapy and local radiotherapy and were followed up for long-term follow-up. The age ranged from 1.5 to 16.5 years (mean, 7.5 years). Histological diagnosis was based on the Kiel classification, including 10 unclassified primary lymphocytes, 2 primitive immunocompetent cells and 9 primitive lymphocytic cells 3 cases. The 29 cases were Ann Ar-bor stage Ⅰ, Ⅱ in 8 cases, stage Ⅳ in 21 cases, no stage Ⅲ. Children generally receive 48 ~ 72 h after hospitalization within the combined chemotherapy. The chemotherapy regimen consisted of doxorubicin, cyclophosphamide, vincristine and prednisone during the two-month induction period. Maintained by six mercaptopurine, methotrexate, doxorubicin, vincristine and prednisone composition. If achieved full response treatment continued for up to 24 months. Ten patients received early response after the induction of mediastinal or abdominal parts of the local radiotherapy. 11 cases made