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目的:探讨套细胞淋巴瘤(MCL)患者的临床特点、治疗与疗效的关系。方法:回顾分析我院16例MCL患者的临床资料,采用MCL国际预后指数(MIPI)和MIPIb(Ki-67)评估,观察短期缓解率和长期疗效,包括2年总生存率及无进展生存率(PFS),分析临床因素对预后的影响。结果:16例患者中,男10例,女6例,男∶女约为3∶2,临床分期Ⅲ~Ⅳ期约占93.8%,所有患者均接受1个疗程以上的CHOP(E)±美罗华(R)等方案化疗。预后因素分析发现:①虽然MIPI<5.7、Ki-67≤40%、β2-GM<3mg/L各组患者分别与MIPI≥5.7、Ki-67>40%、β2-GM≥3mg/L各组患者的短期缓解率无明显差异,但前3个组患者2年PFS率分别明显高于后3个组(66.7%∶25.0%,63.6%∶19.1%,78.9%∶33.5%,均P<0.05);②9例检测SOX-11,阳性率66.7%(6/9),未发现预后相关性;③CHOP(E)+R与PAD方案组的短期完全缓解率及2年PFS率均明显优于CHOP(E)方案组(57.1%∶100%∶0,71.4%∶100%∶11.1%,均P<0.05);④难治/复发患者中,1例行自体造血干细胞移植及2例行含硼替佐米的PAD方案化疗,均获得长期PFS。结论:MCL患者男性多发,多为Ⅲ~Ⅳ期,MIPI指数、Ki-67、β2-GM对临床预后判断有重要作用;SOX-11预后相关性有待深入研究;CHOP(E)+R较CHOP(E)疗效好,PAD方案联合美罗华维持治疗对难治/复发患者的疗效显著,有待进一步临床观察。
Objective: To investigate the clinical characteristics, treatment and curative effect of mantle cell lymphoma (MCL). Methods: The clinical data of 16 MCL patients in our hospital were retrospectively analyzed. The short-term and long-term effects were evaluated by MIPI and MIPIb (Ki-67), including 2-year overall survival and progression-free survival (PFS) to analyze the impact of clinical factors on prognosis. Results: Among the 16 patients, there were 10 males and 6 females, with a ratio of 3: 2 for males and females and 93.8% for stage Ⅲ ~ Ⅳ. All patients received more than one course of CHOP (E) ± ropivacaine (R) and other programs of chemotherapy. Prognostic factors: ①MIPI≥5.7, Ki-67> 40%, β2-GM≥3mg / L in each group of MIPI <5.7, Ki-67≤40%, β2-GM <3mg / L However, the 2-year PFS rates in the first 3 groups were significantly higher than those in the latter 3 groups (66.7%, 25.0%, 63.6%, 19.1%, 78.9%, 33.5%, P <0.05, respectively) ); 9 cases detected SOX-11, the positive rate of 66.7% (6/9), no correlation was found; ③ CHOP (E) + R and PAD regimen group short-term complete remission rate and 2-year PFS rate were significantly better than CHOP (E) group (57.1%: 100%: 0, 71.4%: 100%: 11.1%, all P <0.05) .④In the refractory / relapse group, one patient underwent autologous hematopoietic stem cell transplantation and two patients received boron Tezumi PAD regimen chemotherapy, have long-term PFS. CONCLUSIONS: Multiple MCL patients are mostly stage III-IV. The MIPI index, Ki-67 and β2-GM play an important role in the clinical prognosis. The prognosis of SOX-11 remains to be further studied. The CHOP (E) (E) good effect, PAD program combined with Rituximab maintenance treatment of patients with refractory / relapse significant effect, pending further clinical observation.