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目的探讨套细胞淋巴瘤(mantle cell lymphoma,MCL)临床特征及常规治疗后近期疗效。方法回顾性分析军事医学科学院附属医院2004年8月至2013年10月收治的15例MCL患者的临床资料。结果患者中位发病年龄59岁,男女比例1.5∶1,Ann-Arbor分期Ⅲ~Ⅳ期14例(93%);病灶累及淋巴结15例(100%)、骨髓7例(47%)、胃肠道4例(27%)、眼眶3例(20%)。免疫组化Ki-67阳性率<40%的9例(60%),≥40%的6例(40%);母细胞型1例。一线治疗以CHOP方案为主,其中8例联合利妥昔单抗。患者中位生存期12个月(3~64个月),诱导化疗后总有效率80%。Ki-67<40%组存活7/9例,迄今已生存8~64个月;Ki-67≥40%组存活2/6例,至今已分别生存8、9个月。结论 MCL多发于老年男性,临床生物学行为具有侵袭性,常结外受侵,目前常规化疗疗效有限,形态学表现为母细胞分化、Ki-67高表达的患者预后不佳。
Objective To investigate the clinical characteristics of mantle cell lymphoma (MCL) and its short-term efficacy after routine treatment. Methods The clinical data of 15 MCL patients admitted to the Affiliated Hospital of Academy of Military Medical Sciences from August 2004 to October 2013 were retrospectively analyzed. Results The median age at onset was 59 years. The male-female ratio was 1.5: 1. The Ann-Arbor stage Ⅲ-Ⅳ stage was 14 cases (93%). The lesions involved lymph nodes in 15 cases (100%), bone marrow in 7 cases Road in 4 cases (27%), orbital in 3 cases (20%). Nine cases (60%) with immunohistochemical Ki-67 positive rate <40%, six cases (40%) ≥40% and one case of blastic cell type. The first-line treatment is dominated by CHOP regimen, of which 8 combined with rituximab. The median survival time of patients was 12 months (3-64 months), and the total effective rate was 80% after induction chemotherapy. Ki-67 <40% group survival 7/9 cases, so far has been living for 8 to 64 months; Ki-67≥40% group 2/6 patients survive, so far have survived 8, 9 months. CONCLUSIONS: MCL is more common in older men. The clinical biological behavior is aggressive and often invading. The efficacy of conventional chemotherapy is limited. The morphological features of MCL are dedifferentiated by blast cells. The prognosis of patients with high Ki-67 expression is poor.