目的：弥漫性大B细胞淋巴瘤(diffuse large B cell lymphoma,DLBCL)是非霍奇金淋巴瘤最常见的类型,不同的分类亚型对化疗的反应差别很大,因此研究DLBCL的相关临床指标对评估预后具有重要的意义.本研究探讨DLBCL患者一线标准治疗后随访...
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目的：弥漫性大B细胞淋巴瘤(diffuse large B cell lymphoma,DLBCL)是非霍奇金淋巴瘤最常见的类型,不同的分类亚型对化疗的反应差别很大,因此研究DLBCL的相关临床指标对评估预后具有重要的意义.本研究探讨DLBCL患者一线标准治疗后随访中监测淋巴细胞数(absolute lymphocyte count,ALC)对于预测疾病复发的作用.方法：收集2005年1月至2010年12月在中国医学科学院肿瘤医院收治的144例DLBCL患者的病例资料.所有患者均为初治并且组织病理均经过中国医学科学院肿瘤医院病理科确诊.一线治疗后随访期间定期监测ALC,分析复发或末次随访时ALC的差异,评价监测ALC对于DLBCL疾病复发的预测作用.结果：144例初治DLBCL患者一线标准治疗后随访期间复发者80例,至末次随访未复发者64例.根据复发或末次随访时间ALC绘制ROC曲线得到界限值1.51×109/l,将144例DLBCL患者分为ALC≥1.51×109/l组(79例)和ALC＜ 1.51×109/l组(65例),在ALC＜1.51×109/l组患者中,疾病复发累积风险率(Hazard Rate,HR)为5.070(95％可信区间3.131-8.210),明显高于ALC≥1.51×109/l组(HR=0.197,95％可信区间0.122-0.319),差异显著(P＜0.001),且与LDH是否升高无关(P＜ 0.001).单因素分析表示年龄、临床分期、结外受侵数、诊断时LDH、IPI评分、复发或末次随访时ALC及LDH与疾病是否复发有关(P＜0.05);多因素分析表示临床分期、复发或末次随访时ALC,复发或末次随访时LDH是预测疾病复发的独立因素.结论：DLBCL一线治疗后随访期间出现ALC减少是疾病复发的有效预测因子.
Background: Because there are currently many effective therapies available for Sé zary syndrome, close monitoring of disease progression is required in order for a clinician to know when to institute or change an...
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Background: Because there are currently many effective therapies available for Sé zary syndrome, close monitoring of disease progression is required in order for a clinician to know when to institute or change an intervention. It has been our clinical experience that changes in patients’ CD4+ CD26- T- cell populations of peripheral blood lymphocytes herald changes in their clinical status. Objective: Our purpose was to evaluate whether a change in patients’ CD4+ CD26- population of T cells presages a change in their clinical status. We also sought to investigate the association between a change in Tcell populations that are CD4+ CD7- , CD8+ , CD56+ , and the CD4 + /CD8+ T- cell ratio and a change in the patient’ s clinical status. Methods: We conducted a retrospective chart review analysis of 21 patients with Sé zary syndrome who had flow cytometry, usually including levels of CD4+ CD26- , CD4+ CD7- , CD8+ , CD56+ , and CD4+ /CD8+ ratios measured at two time periods, 12 weeks apart. Results: We report two cases in which changes in patients’ clinical status were preceded by several weeks by a change in their CD4+ CD26- level. We report weak associations between a decreasing CD4+ CD26- T- cell population, a decreasing CD4+ CD7- population, an increasing CD56+ population, and an improving clinical status. We also report stronger associations between both a decreasing CD8+ population and an increasing CD4+ /CD8+ ratio and a worsening clinical status. Limitations: The study was limited by the number of patients and the time period over which the study was conducted. In addition, varying configurations of CD4+ CD26- T- cell populations were observed that may have limited the utility of this measurement. Conclusions: Flow cytometry assays of patients’ blood and, in particular, measurement of the CD4+ CD26- population of lymphocytes over time may be a valuable tool for monitoring patients with Sé zary syndrome. There exist varying configurations of CD26 T lymphocytes that m
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