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Pathogenic Features and Prognosis of36Cases of Peripheral T Cell Lymphoma

Author: ZhouZuo
Tutor: LuoJianMin
School: Hebei Medical University
Course: Internal Medicine
Keywords: non Hodgkin lymphoma (NHL) peripheral T cell lymphoma(PTCL) clinical feature remedy prognostic factors survival rate
CLC: R733.1
Type: Master's thesis
Year: 2012
Downloads: 71
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Abstract


Objective: Sort out and analyze peripheral T cell lymphoma (peripheralT-cell lymphoma,PTCL)’s clinical features, common remedies, resent curativeeffects, future survival, disease prognosis, etc, providing references for theclinical condition monitoring and prognosis evaluation of the disease.Method: Review retrospectively36cases of PTCL patients with collectableand complete medical records of Hebei medical university second affiliatedhospital during January2009to January2012; conduct histopathologicalclassification of these cases according to REAL and WHO (2008); analyzeclinical features, common remedies, resent curative effects, future survival,disease prognosis of the patients.Results:36cases of diagnosed PTCL patients account for22.5%of all theNHL patients in our hospital during the same time period, roughly the same asthe rate of the disease-20%-in our country.Conducting histopathologicalclassification of these cases according to REAL, WHO (2008), and lymphaticsystem cancer. Among them the15cases of NK/T cell lymphoma account for41.67%,8cases of Vascular immune mother cells T cell lymphoma accountfor22.22%,3cases of Between ALK+bigger cell lymphoma account for8.33%,3cases of PTCL peripheral T celll lymphoma NOS account for8.33%,3cases of NK/T Bowel disease correlation T cell lymphoma account for8.33%,2cases of Liver and spleen T cell lymphoma account for5.56%,1cases of Aggressive NK cell leukemia account for2.78%,1cases of Primaryskin peripheral T cell lymphoma rare subtype account for2.78%. There are27cases of male patients, while female patients account for9cases. Median ageof the diagnosed patients is48(4-76), with2cases of agebelow18,11casesof age between18and40,18cases of age between40to65,5cases of ageabove65.12cases of Ⅰ/Ⅱstages of clinical stage account for33.33%, and24 cases of Ⅲ/Ⅳ stages of clinical stage account for33.33%.26cases withGroup B symptoms—fever, sweating, marasmus—account for72.22%, and10cases with Group A symptoms account for27.78%.18cases of LDH increasedaccount for50.0%,15cases of Serum beta2micro globulin value higher thannormal account for41.67%,16cases of serum albumin deficiency account for44.44%. o case of IPI<2,8cases of IPI=2account for22.22%,15cases ofIPI=3account for41.67,13cases of IPI≧4account for36.11%.23patientsaccepted chemotherapy,7patients accepted radiotherapy combined withchemotherapy, and1patient accepted chemotherapy.1patient acceptedhemopoietic stem cell after relieved from chemotherapy, the other4patientsceased treatments. As for the follow-up of diagnosed patients, medianfollow-up is8(1-34) months, among which15patients died,8patients lost tofollow-up,7patients accepted regular reexamination after therapy iscompleted,3patients are still being treated,3patients are taking oralmedication. The survival rate is85.0%within half a year,76.0%within1year,54%within2years,13.0%within3years. Single factor analysis indicates thatⅢ/Ⅳstage of the disease, Group B symptoms, increase of LDH and IPIgrading are factors associated with poor outcome, while multivariate analysisshows that the increase of serum beta2micro globulin value is theindependent prognostic indicators of PTCL(P<0.05).Conclusion: PTCL has characteristics as following: low morbidity, strongheterogeneity, difficulty in disease classification, already in late stage duringthe attack, disease is aggressive with rapid growth, no first-line therapyavailable, poor prognosis, etc. The remedy of PTCL is still CHOP(cyclophosphamide+doxombicin+vincristine+metacortandracin) and CHOPchemotherapy.With in-depth study of the disease, though there are remedieslike forceful chemotherapy such as Hyper-CVAD and EPOCH, radiotherapy,new drugs, and hematopoietic stem cell, etc, which can increase short termeffect, long term survival rate is still need to be improved because of the lackof cases. Treatments of the disease are listed as following: early diagnosis andpositive treatment, paying attention to clinical characteristics of the patients, reinforcing detection of indicators like blood biochemistry, pathology ofmarrow and lymph gland, immunohistochemistry and image feature, insistingon the follow-up of these patients, constantly exploring optimal treatments.These treatments will be significant to the improvement of disease prognosis.

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CLC: > Medicine, health > Oncology > Hematopoietic and lymphoid neoplasms > Reticuloendothelial system tumors
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