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目的:总结分析儿童、青少年非霍奇金淋巴瘤(non-Hodgkin lymphoma,NHL)临床特征、预后因素、化疗方案及疗效。方法:选取南京医科大学第一附属医院2009年9月—2015年12月收治的68例NHL患者,收集临床资料,总体生存(overall survival,OS)、无事件生存(event free survival,EFS)统计分析用Kaplan-Meier方法,组间生存情况比较用Log-rank检验。结果:68例NHL患者中,男45例,女23例,中位年龄17岁(2~20岁);包括成熟B-NHL 33例,NK/T-NHL 22例,淋巴母细胞淋巴瘤13例。58例化疗患者进行了生存分析,1年、3年、5年OS率分别为80.7%、70.5%和70.5%,EFS率分别为61.1%、56.3%和56.3%。29例成熟B-NHL接受利妥昔单抗组与未接受利妥昔单抗治疗组5年OS率分别为93.3%和66.7%(P=0.038);造血干细胞移植(hematopoietic stem cell transplantation,HSCT)组与非HSCT组5年EFS率分别为80.0%和46.8%(P=0.050)。患者疾病分期、疾病免疫分型、白蛋白水平与OS有关(P=0.050)。结论:儿童、青少年NHL多见于男性,Ⅲ、Ⅳ期比例高,利妥昔单抗靶向治疗、HSCT可提高OS和EFS,预后与疾病分期、免疫分型和白蛋白水平相关。
Objective: To summarize and analyze the clinical features, prognostic factors, chemotherapy regimens and therapeutic effects of non-Hodgkin lymphoma (NHL) in children and adolescents. Methods: A total of 68 patients with NHL admitted to the First Affiliated Hospital of Nanjing Medical University from September 2009 to December 2015 were enrolled in this study. Clinical data, overall survival (OS) and event free survival (EFS) statistics were collected. Analysis by Kaplan-Meier method, the survival between groups by Log-rank test. Results: Of the 68 patients with NHL, 45 were male and 23 were female, with a median age of 17 years (ranging from 2 to 20 years). There were 33 patients with mature B-NHL, 22 with NK / T-NHL and 13 with lymphoblastic lymphoma example. Survival analysis was performed in 58 patients with chemotherapy. The 1-year, 3-year and 5-year OS rates were 80.7%, 70.5% and 70.5%, respectively. The EFS rates were 61.1%, 56.3% and 56.3%, respectively. The 5-year OS rates of 29 patients with mature B-NHL receiving rituximab and those without rituximab were 93.3% and 66.7%, respectively (P = 0.038); hematopoietic stem cell transplantation (HSCT The 5-year EFS rates in the non-HSCT group were 80.0% and 46.8%, respectively (P = 0.050). Patient’s disease stage, disease immunophenotype, albumin level and OS (P = 0.050). Conclusion: NHL is more common in children and adolescents than in men. The proportion of stage Ⅲ and Ⅳ is high. Rituximab is targeted therapy. HSCT can improve OS and EFS. Prognosis is correlated with stage of disease, immunophenotype and albumin level.