上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

非霍奇金淋巴瘤合并噬血细胞综合征的临床与预后分析

肖慧芳1,2，郝 杰3*，赵维莅1，王 黎1   

  1. 1.上海交通大学 医学院附属瑞金医院血液科，上海 200025；2.福建医科大学附属泉州第一医院血液科，泉州 362000；3.上海交通大学 医学院附属瑞金医院血液科联合病房，上海 200070
  • 出版日期:2016-08-29 发布日期:2016-08-31
  • 通讯作者: 王 黎，电子信箱：wl_wangdong@126.com。
  • 作者简介:肖慧芳（1981—），女，主治医师，硕士生；电子信箱：huifang603@163.com。郝 杰（1970—），女，副主任医师，硕士；电子信箱：haojunxin@163.com。*并列第一作者。
  • 基金资助:

    上海市教育委员会高峰高原学科建设计划（201522060）；上海市科学技术委员会项目（14430723400,14140903100）

Clinical and prognostic analyses of non-Hodgkin lymphoma combined with hemophagocytic syndrome

XIAO Hui-fang1,2, HAO Jie3*, ZHAO Wei-li1, WANG li1   

  1. 1. Department of Hematology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China; 2 Department of Hematology, First Quan-zhou Hospital, Fujian Medical University, Quan Zhou362000, China; 3. Department of Hematology, North Station Hospital of Shanghai, Shanghai 200070, China
  • Online:2016-08-29 Published:2016-08-31
  • Supported by:

    Shanghai Municipal Education Commission—Gaofeng Clinical Medicine Grant Support，201522060；Project of Shanghai Municipal Science and Technology Commission, 14430723400, 14140903100

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摘要：

目的·比较非霍奇金淋巴瘤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·对2006年1月—2014年5月住院治疗的非霍奇金淋巴瘤合并HPS患者33例（合并HPS组）及同时期未合并HPS的非霍奇金淋巴瘤患者76例（对照组）进行回顾性分析。采用Kaplan-Meier法进行生存分析，利用Cox回归模型对可能影响生存的因素进行单因素和多因素分析。结果·合并HPS组多以发热起病，大部分骨髓样本（29/33）中可以找到噬血细胞，血清铁蛋白、三酰甘油、总胆红素和乳酸脱氢酶（LDH）明显升高，分期晚、体能状态差、病情重，总体预后较对照组差（P=0.000）。合并HPS及治疗未达完全缓解是非霍奇金淋巴瘤患者预后差的独立危险因素。结论·非霍奇金淋巴瘤合并HPS的患者病情重，总体预后较差。

关键词: 非霍奇金淋巴瘤, 噬血细胞综合征, 临床特征, 预后

Abstract:

Objective · To compare the clinical features and prognosis between non-Hodgkin lymphoma (NHL) patients with and without hemophagocytic syndrome (HPS). Methods · A retrospective analysis was performed for 33 NHL patients with HPS (the HPS group) and 76 NHL patients without HPS (the control group) admitted from January 2006 to May 2014. Survival analysis was conducted with Kaplan-Meier method and univariate and multivariate analyses were carried out by using a COX regression model for factors that might affect the survival of patients. Results · The NHL patients with HPS were likely to start with fever. Most bone marrow samples (29/33) had elevated serum ferritin, triglyceride, total bilirubin, and lactate dehydrogenase (LDH) and hemophagocytes could be found in these samples. The NHL patients with HPS had late disease stage, poor physical ability, and severe disease status and their prognosis was poorer compared with controls (P=0.000). Failure to achieve complete remission and the combination of HPS were independent risk factors for poor prognosis of NHL patients. Conclusion · The NHL patients with HPS have severe disease status and poor prognosis.

Key words: non-Hodgkin lymphoma, hemophagocytic syndrome, clinical features, prognosis