首页|弥漫大B细胞淋巴瘤初诊时合并噬血细胞综合征的临床特征与预后分析

弥漫大B细胞淋巴瘤初诊时合并噬血细胞综合征的临床特征与预后分析

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目的:比较弥漫大B细胞淋巴瘤初诊时合并噬血细胞综合征(HPS)与不合并HPS患者的临床特征和预后差异.方法:回顾性分析2012年1月至2021年12月就诊甘肃省人民医院的45例弥漫大B细胞淋巴瘤患者的临床资料,按初诊时是否伴HPS分为合并HPS组(15例)和不合并HPS组(30例),比较两组患者临床特征及预后差异,并应用Kaplan-Meier法进行生存分析.结果:合并HSP组的患者多以发热、血细胞减少、脾大为突出表现;所有患者铁蛋白、可溶性CD25水平升高;66.67%的患者纤维蛋白原水平降低,53.33%的患者甘油三酯水平升高,80.00%的患者出现骨髓噬血现象.与不合并HSP组相比,合并HSP组的进展期(Ann Arbor分期Ⅲ/Ⅳ期)患者和乳酸脱氢酶≥240 U/L患者所占比例较高(均P<0.05).合并HSP组中位生存时间为8.0个月,而不合并HSP组的中位生存时间为45.5个月,比较差异有统计学意义(P<0.001).结论:弥漫大B细胞淋巴瘤初诊时合并HPS的患者与不合并HPS的患者相比,Ann Arbor分期晚、乳酸脱氢酶水平高,总体生存时间较短.
Clinical Features and Prognostic Analysis of Newly Diagnosed Diffuse Large B-cell Lymphoma Combined with Hemophagocytic Syndrome
Objective:To compare the clinical features and prognosis between newly diagnosed diffuse large B-cell lymphoma(DLBCL)patients with and without hemophagocytic syndrome(HPS).Methods:The clinical data of 45 DLBCL patients in Gansu Provincial Hospital from January 2012 to December 2021 were retrospectively analyzed.The patients were divided into HPS group(15 cases)and non-HPS group(30 cases).The clinical features and prognosis of the two groups were compared,and survival analysis was performed using Kaplan-Meier method.Results:Patients with HSP were mostly characterized by fever,cytopenia and splenomegaly.The levels of ferritin and soluble CD25 increased in all patients.The level of fibrinogen decreased in 66.67%patients,while triglyceride increased in 53.33%patients,and bone marrow hemophagocytosis occurred in 80.00%patients.Compared with non-HSP group,the proportions of patients with advanced stage(Ann Arbor stage Ⅲ/Ⅳ)and lactate dehydrogenase(LDH)≥ 240 U/L were higher in HSP group(both P<0.05).The median survival time of HSP group was 8.0 months,which was significantly shorter than 45.5 months of non-HSP group(P<0.001).Conclusion:The DLBCL patients with HPS have later Ann Arbor stage,higher LDH and shorter overall survival time compared with patients without HPS.

diffuse large B-cell lymphomahemophagocytic syndromeclinical featuresprognosis

魏小芳、冯友繁、伏媛、刘菲、陈巧琳、张启科

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甘肃省人民医院血液科,甘肃兰州 730000

弥漫大B细胞淋巴瘤 噬血细胞综合征 临床特征 预后

甘肃省自然科学基金甘肃省青年科技项目

21JR1RA02321JR11RA201

2024

中国实验血液学杂志
中国病理生理学会

中国实验血液学杂志

CSTPCD北大核心
影响因子:0.988
ISSN:1009-2137
年,卷(期):2024.32(2)
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