【摘 要】
：
目的：探讨年轻极高危滤泡性淋巴瘤(follicular lymphoma,FL)的强化治疗及其合理性.方法：回顾性分析我院采用强化治疗+自体移植的3例极年轻极高危FL的情况及治疗结果,并回顾、复习FL治疗的经典文献,比较其临床特点.结果：三例患者均为30岁以下高危FL患者,包括1例29岁,白血病倍增时间短且17p-阳性;1例19岁：FL3A级FLIPI4分患者和1例18岁FLIPI3分患者,经4～
【机 构】
：
中国医学科学院血液学研究所血液病医院淋巴瘤中心
【出 处】
：
第八届中国肿瘤内科大会、第三届中国肿瘤医师大会暨中国抗癌协会肿瘤临床化疗专业委员会2014年学术年会
论文部分内容阅读
目的：探讨年轻极高危滤泡性淋巴瘤(follicular lymphoma,FL)的强化治疗及其合理性.
方法：回顾性分析我院采用强化治疗+自体移植的3例极年轻极高危FL的情况及治疗结果,并回顾、复习FL治疗的经典文献,比较其临床特点.
结果：三例患者均为30岁以下高危FL患者,包括1例29岁,白血病倍增时间短且17p-阳性;1例19岁：FL3A级FLIPI4分患者和1例18岁FLIPI3分患者,经4～6疗程化疗达到CR或PR后,进行自体干细胞移植,现移植后均无病生存4～5年.文献复习：目前国内外指南均将利妥昔单抗联合化疗作为一线治疗选择.指南依赖的证据均为多中心随机对照研究.一线强化治疗的临床研究均不支持一线自体移植可提高OS.因此,自体移植一般不作为FL的一线治疗.但比较该组3例患者与上述所有临床研究入组患者情况：从年龄看,总共1000余例入组患者,化疗患者中位年龄接近60岁,即使入组移植研究的患者,中位年龄也在50岁左右;从危险分层看,FLIPI≥3分的高危患者占19％-56％,总起来不足半数.
结论：主要来自于中老年FL患者的临床研究结果及指南推荐,不一定适合作为年轻患者的治疗依据.对于少见的极年轻、极高危患者,采用强化治疗并不悖于指南推荐.
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