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目的分析 B 淋巴母细胞淋巴瘤的临床特点和采用改良 BFM-90淋巴母细胞淋巴瘤方案的治疗结果。方法对14例 B 淋巴母细胞淋巴瘤患者的临床表现进行分析,与同期住院的 T 淋巴母细胞淋巴瘤的临床表现进行比较。并对采用改良 BFM-90淋巴母细胞淋巴瘤方案治疗的疗效和不良反应进行初步分析。结果 14例 B 淋巴母细胞淋巴瘤患者,年龄3～18岁,经病理检查和免疫组化检测证实为 B 淋巴母细胞淋巴瘤。其中 I 期1例,Ⅲ期2例,Ⅳ期11例。以侵犯淋巴结和皮肤和骨髓最多见,分别占71%,50%和64%。除1例早期患者采用 CHOP+HD-MTX 化疗,其余13例均采用改良 BFM-90淋巴母细胞淋巴瘤方案化疗,其中12例患者(92.3%)获得完全缓解,1例患者(7.7%)获得部分缓解。中位随访19.5(2～44)个月,1例部分缓解患者放弃治疗后死亡,其余13例患者目前仍存活。近期疗效好,远期疗效仍须要继续随访。主要的不良反应为骨髓抑制,但均可耐受。结论 B淋巴母细胞淋巴瘤侵犯部位多为淋巴结、骨髓和皮肤,采用改良 BFM-90淋巴母细胞淋巴瘤方案治疗可改善疗效。
Objective To analyze the clinical features of B lymphoblastic lymphoma and the results of treatment with modified BFM-90 lymphoblastic lymphoma. Methods The clinical manifestations of 14 patients with B lymphoblastic lymphoma were analyzed and compared with those of hospitalized T lymphoblastic lymphoma over the same period. The primary efficacy and adverse reactions of the modified BFM-90 lymphoblastic lymphoma regimen were analyzed. Results 14 cases of B lymphoblastic lymphoma patients aged 3 to 18 years old, confirmed by pathological examination and immunohistochemistry as B lymphoblastic lymphoma. One case of stage I, 2 cases of stage III, 11 cases of stage IV. Inflammatory lymph nodes and skin and bone marrow are the most common, accounting for 71%, 50% and 64% respectively. Chemotherapy with CHOP + HD-MTX chemotherapy was used in one of the early patients, while the remaining 13 patients were treated with modified BFM-90 lymphoblastic lymphoma chemotherapy. Twelve patients (92.3%) achieved complete remission and one patient (7.7%) achieved chemotherapy Partial relief. After a median follow-up of 19.5 (range 2-44) months, one patient with partial remission died after giving up treatment and the remaining 13 patients were still alive. Short-term curative effect, long-term curative effect still needs to be followed up. The main adverse reaction was myelosuppression, but both were tolerable. Conclusion B lymphoblastic lymphoma invading sites mostly lymph nodes, bone marrow and skin, the use of modified BFM-90 lymphoblastic lymphoma regimen can improve the therapeutic effect.