目的 总结血管免疫母细胞性T细胞淋巴瘤(AITL)的临床特点并探讨其预后因素.方法 收集1994年6月-2010年6月诊治的25例AITL患者的临床资料及随访信息,进行生存分析.结果 患者男女比例为2.6∶1,中位年龄54岁.患者起病时均有淋巴结肿大,诊断时80.0％(20/25)为Ⅲ/Ⅳ期,60.0％(15/25)伴有全身症状.血清β2微球蛋白升高和血清乳酸脱氢酶升高分别为44.0％(11/25)和32.0％(8/25).全组患者以含蒽环类药物的联合化疗治疗为主.化疗后可评价疗效24例,完全缓解33.3％(8/24)、部分缓解29.2％(7/24)、稳定4.2％(1/24)、进展33.3％(8/24).治疗后1、3、5年无病生存与总生存率分别为28.0％、24.0％和24.0％与72.0％、44.0％和32.0％.单因素分析结果,Ann-Arbor分期Ⅰ/Ⅱ期患者和联合化疗达到完全缓解的患者总生存期和无病生存期显著延长(P＜0.05),女性总生存优于男性(P＜0.05),但无病生存差异无统计学意义(P＞0.05),国际预后指数(IPI)与生存无显著相关(r=-0.365,P＞0.05).结论 AITL以老年、晚期患者多见,预后差.Ann-Arbor分期Ⅰ/Ⅱ期和初始联合化疗可达到完全缓解,改善预后.%Objective To retrospectively summarize the clinical features and discuss factors affecting the prognosis of angioimmunoblastic T cell lymphoma(AITL).Methods Clinical data and follow up information of 25 patients with AITL in the department from Jun.1994 to Jun.2010 were collected and analyzed.Chemotherapy was the main approach,and regimens were anthracycline based combined chemotherapy regimens.Results The median age of the 25 patients was 54 years;the male to female ratio was 2.6∶1.All of the 25 patients had lymph node enlargements,80.0％ were in Ann Arbor stage Ⅲ or Ⅳ,60.0％ (15/25) presented with B symptom.44.0％ (11/25) elevated in β2-MG,32.0％ (8/25) in LDH.After treatment 24 cases were evaluatable,33.3％ (8/24) achieved complete remission,29.2％ (7/24) achieved partial remission,and 4.2％ (1/24) patients achieved stable and 33.3％ (8/25) patient' s progress.The median survival was 44 months.1,3,and 5 year disease free survival were 28.0％,24.0％ and 24.0％ respectively,and overall survival were 72.0％,44.0％ and 32.0％ respectively.In the univariate analysis,patients who received complete remission from initial treatment and who were in early stages had significantly superior progression free survival and overall survival respectively.Male also had adversely affected overall survival.International prognosis index (IPI) seems to be insignificant with the outcome (r =-0.365,P ＞0.05).Conclusion The AITL is generally more common in elderly patients and in clinical advanced stages,having a poorprognosis.Received complete remission from initial treatment and early stage are associated with good outcome.
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