中国当代儿科杂志
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中国当代儿科杂志  2018, Vol. 20 Issue (6): 470-474    DOI:10.7499/j.issn.1008-8830.2018.06.008
论著·临床研究 最新目录| 下期目录| 过刊浏览| 高级检索 |
儿童成熟B细胞非霍奇金淋巴瘤临床特点及预后分析
陈再生1, 郑湧智1, 陈以乔1, 高琴丽1, 李健1, 沈建箴2
1. 福建省血液病研究所/福建省血液病学重点实验室/福建医科大学附属协和医院小儿血液科, 福建 福州 350001;
2. 福建省血液病研究所/福建省血液病学重点实验室/福建医科大学附属协和医院血液科, 福建 福州 350001
Clinical features and prognosis of children with mature B-cell non-Hodgkin's lymphoma: an analysis of 28 cases
CHEN Zai-Sheng1, ZHENG Yong-Zhi1, CHEN Yi-Qiao1, GAO Qin-Li1, LI Jian1, SHEN Jian-Zhen2
Fujian Institute of Hematology/Fujian Provincial Key Laboratory on Hematology/Fujian Medical University Union Hospital, Fuzhou 350001, China
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摘要 目的 了解儿童成熟B细胞非霍奇金淋巴瘤(B-NHL)的临床特征和治疗结局。方法 28例患儿均以CCCG-B-NHL 2010方案化疗,其中20例联合美罗华治疗,随访31(4~70)个月。回顾性分析患儿的临床特征,以Kaplan-Meier法进行生存分析,并且进行预后因素的单因素分析。结果 28例患儿中伯基特淋巴瘤(BL)17例(61%),弥漫大B细胞型淋巴瘤(DLBCL)8例(29%),3 例(11%)未能进一步分类。首发表现为颈部肿物的13例(46%),颌面部肿物10例(36%),肝脾大9例(32%),腹部包块5例(18%),突眼5例(18%)。LDH<500 U/L者14例,500~1 000 IU/L者3例,≥1 000 IU/L者11例。化疗2疗程后,21例完全缓解、7例部分缓解,截至随访末期,24例持续完全缓解、4例复发。2年无事件生存率为85.7±6.6%。骨髓活检提示骨髓浸润、LDH≥500 IU/L、骨髓肿瘤细胞 > 25%的成熟B-NHL患儿2年累积生存率较低。结论 CCCG-B-NHL 2010方案联合美罗华治疗儿童B-NHL疗效满意,骨髓活检发现的骨髓浸润与不良预后相关。
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陈再生
郑湧智
陈以乔
高琴丽
李健
沈建箴
关键词 成熟B细胞非霍奇金淋巴瘤美罗华无事件生存率预后儿童    
Abstract:Objective To study the clinical features and treatment outcome of children with mature B-cell non-Hodgkin's lymphoma (B-NHL). Methods A total of 28 previously untreated children with mature B-NHL were enrolled and given the chemotherapy regimen of CCCG-B-NHL-2010. Among them, 20 were given rituximab in addition to chemotherapy. The children were followed up for 31 months (ranged 4-70 months). A retrospective analysis was performed for the clinical features of these children. The Kaplan-Meier method was used for survival analysis. A univariate analysis was performed to investigate the prognostic factors. Results Among the 28 children, 17 (61%) had Burkitt lymphoma, 8 (29%) had diffuse large B-cell lymphoma (DLBCL), and 3 (11%) had unclassifiable B-cell lymphoma. As for the initial symptom, 13 (46%) had cervical mass, 10 (36%) had maxillofacial mass, 9 (32%) had hepatosplenomegaly, 5 (18%) had abdominal mass, and 5 (18%) had exophthalmos. Of all children, 14 had a lactate dehydrogenase (LDH) level of < 500 IU/L, 3 had a level of 500-1 000 IU/L, and 11 had a level of ≥ 1 000 IU/L. After two courses of chemotherapy, 21 children achieved complete remission and 7 achieved partial remission. At the end of follow-up, 24 achieved continuous complete remission and 4 experienced recurrence. The 2-year event-free survival rate was (85.7±6.6)%. The children with bone marrow infiltration suggested by bone marrow biopsy, serum LDH ≥500 IU/L, and bone marrow tumor cells > 25% had a low 2-year cumulative survival rate. Conclusions The CCCG-B-NHL 2010 chemotherapy regimen combined with rituximab has a satisfactory effect in the treatment of children with B-NHL. Bone marrow infiltration on bone marrow biopsy is associated with poor prognosis.
Key wordsMature B-cell non-Hodgkin's lymphoma    Rituximab    Event-free survival rate    Prognosis    Child   
收稿日期: 2018-01-04     
基金资助:福建省血液医学中心建设项目资助(闽政办(2017)4号)。国家和福建省临床重点专科建设项目资助。
通讯作者: 沈建箴,男,主任医师,教授。Email:732280153@qq.com     E-mail: 732280153@qq.com
作者简介: 陈再生,男,硕士,副主任医师。
引用本文:   
陈再生,郑湧智,陈以乔等. 儿童成熟B细胞非霍奇金淋巴瘤临床特点及预后分析[J]. 中国当代儿科杂志, 2018, 20(6): 470-474.
CHEN Zai-Sheng,ZHENG Yong-Zhi,CHEN Yi-Qiao et al. Clinical features and prognosis of children with mature B-cell non-Hodgkin's lymphoma: an analysis of 28 cases[J]. CJCP, 2018, 20(6): 470-474.
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