绝对淋巴细胞计数在结外弥漫大B细胞淋巴瘤中的临床意义

邹志兰; 顾伟英; 王志林; 严峰; 孙冠星; 李青; 曹祥山

绝对淋巴细胞计数在结外弥漫大B细胞淋巴瘤中的临床意义

- 苏州大学附属第三医院常州市第一人民医院血液科(江苏常州, 213003)

详细信息

通讯作者: 顾伟英,E-mail:guweiying2001@163.com

中图分类号: R733.4

收稿日期: 2012-06-26

The clinical significance of absolute lymphocyte count in extranodal diffuse large B cell lymphoma patients

- Department of Hematology, the First People's Hospital, Changzhou, Third Affiliated Hospital, Suzhou University, Changzhou, 213003, China

More Information

Corresponding author: GU Weiying, E-mail: guweiying2001@163.com

Received Date: 26 June 2012

摘要

摘要: 目的：探讨结外弥漫大B细胞淋巴瘤（DLBCL）患者初发时外周血绝对淋巴细胞计数（ALC）与其临床特征的关系及对预后的影响。方法：回顾性分析初发的结外DLBCL患者的临床特征及疗效，分析不同ALC水平与结外DLBCL患者各临床特征关系及其预后的相关性。结果：本组59例结外DLBCL患者，以ALC=1.0×10⁹/L为分界点，ALC减少组18例（ALC<1.0×10⁹/L），ALC非减少组41例（ALC>1.0×10⁹/L），2组性别、年龄、LDH水平、ECOG评分、IPI预后指数等临床特征差异无统计学意义（均P>0.05），但ALC减少组常伴有临床分期的升高及non-GCB型增多（均P<0.05），且临床缓解率相对较低（P<0.05）；P53缺失、Bcl-6及c-myc基因的异常表达与ALC高低均无相关性（P>0.05）。结论：ALC减少可以作为结外DLBCL患者的辅助性预后判断指标。
- 弥漫大B细胞淋巴瘤,结外 /
- 绝对淋巴细胞绝对数 /
- 预后
Abstract: Objective: To investigate the clinical significance and prognostic value of peripheral blood absolute lymphocyte count(ALC) for patients with extranodal diffuse large B cell lymphoma at admission.Method: Clinical features, immuno-pathological type, genetic markers and therapeutic effect of 59 patients with pathologically confirmed extranodal diffuse large B cell lymphoma were retrospectively reviewed.The relationship between different ALC levels and the clinical features, immuno-pathological type, genetic markers and therapeutic effect of extranodal diffuse large B cell lymphoma patients was statistically analyzed.Result: In this study, the average age of all 59 patients with extranodal diffuse large B cell lymphoma was 61.8 years.Taking ALC=1.0×10⁹/L as cut-off points, 18 patients with lymphopenia (ALC<1.0×10⁹/L) at diagnosis were prone to manifeste with later clinical stage(P<0.05) and non-GCB subtypes(P<0.05), achieving a lower rate of overall reaction rate (ORR)(P<0.05) comparing with 41 cases without lymphopenia(ALC>1.0×10⁹/L).No relationships were found between ALC level and age, gender, ECOG performance score, LDH level, IPI score, P53 gene deletion, overexpression of Bcl-6 gene or rearrangement of c-myc gene.Conclusion: Our data suggest that ALC at diagnosis is a novel, quite simple predictor of prognosis for patients with extranodal diffuse large B cell lymphoma.
- diffuse large B cell lymphoma, extranodal /
- absolute lymphocyte count /
- prognosis

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参考文献(15)

[1]	EGE H, GERTZ M A, MARKOVIC S N, et al.Prediction of survival using absolute lymphocyte count for newly diagnosed patients with multiple myeloma:a retrospective study[J].Br J Haematol, 2008, 141:792-798.
[2]	JACOBS N L, HOLTAN S G, PORRATA L F, et al.Host immunity affects survival in myelodysplastic syndromes:Independent prognostic value of the absolute lymphocyte count[J].Am J Hematol, 2010, 85:160-163.
[3]	FENG J, WANG Z, GUO X, et al.Prognostic significance of absolute lymphocyte count at diagnosis of diffuse large B-cell lymphoma:a meta-analysis[J].Int J Hematol, 2012, 95:143-148.
[4]	KIM D H, BAEK J H, CHAE Y S, et al.Absolute lymphocyte counts predicts response to chemotherapy and survival in diffuse large B-cell lymphoma[J].Leukemia, 2007, 21:2227-2230.
[5]	PORRATA L F, RISTOW K, HABERMANN T M, et al.Absolute lymphocyte count at the time of first relapse predicts survival in patients with diffuse large B-cell lymphoma[J].Am J Hematol, 2009, 84:93-97.
[6]	PORRATA L F, INWARDS D J, ANSELL S M, et al.New-onset lymphopenia assessed during routine follow-up is a risk factor for relapse postautologous peripheral blood hematopoietic stem cell transplantation in patients with diffuse large B-cell lymphoma[J].Biol Blood Marrow Transplant, 2010, 16:376-383.
[7]	AOKI T, NISHIYAMA T, IMAHASHI N, et al.Lymphopenia following the completion of first-line therapy predicts early relapse in patients with diffuse large B cell lymphoma[J].Ann Hematol, 2012, 91:375-382.
[8]	HANS C P, WEISENBURGER D D, GREINER T C, et al.Confirmation of the molecular classification of diffuse large B-cell lymphoma by immunohistochemistry using a tissue microarray[J].Blood, 2004, 103:275-282.
[9]	NIITSU N.Current treatment strategy of diffuse large B-cell lymphomas[J].Int J Hematol, 2010, 92:231-237.
[10]	JANG G, YOON D H, KIM S, et al.Addition of rituximab to the CHOP regimen has no benefit in patients with primary extranodal diffuse large B-cell lymphoma[J].Korean J Hematol, 2011, 46:103-110.
[11]	TALAULIKAR D, CHOUDHURY A, SHADBOLT B, et al.Lymphocytopenia as a prognostic marker for diffuse large B cell lymphomas[J].Leuk Lymphoma, 2008, 49:959-964.
[12]	舒文秀, 乐静, 万斌, 等.淋巴细胞绝对数减少在非霍奇金淋巴瘤中的临床意义[J].临床血液学杂志, 2011, 24(5):273-275.
[13]	GISSELBRECHT C, GLASS B, MOUNIER N, et al.Salvage regimens with autologous transplantation for relapsed large B-cell lymphoma in the rituximab era[J].J Clin Oncol, 2010, 28:4184-4190.
[14]	ZHUXIA J, JINYUAN H, LING C, et al.P53 deletion is independently associated with increased age and decreased survival in a cohort of Chinese patients with diffuse large B-cell lymphoma[J].Leuk Lymphoma, 2012:1-12.
[15]	YOON S, JEON Y, PAIK J, et al.MYC translocation and an increased copy number predict poor prognosis in adult diffuse large B-cell lymphoma (DLBCL), especially in germinal centre-like B cell (GCB) type[J].Histopathology, 2008, 53:205-217.