Objective: To study the clinical features, therapeutic effects, prognostic factors of 140 patents with mantle cell lymphoma (MCL). Methods: Clinical data of 140 MCL patients admitted from June 2009 to January 2016 in our hospital were retrospectively analyzed. Results: The median age of 140 patients was 59 years with a ratio of 6∶1 for men and women. There were 134 cases (95.7%) in Ann-Arbor stage Ⅲ-Ⅳ, 37 cases (26.4%) with B symptoms, 61 cases (43.6%) with bone marrow involvement and 38 cases (27.1%) with enlarged spleen. The overall response rate (ORR), 3-year survival rate and progression-free survival rate in the treatment group with rituximab were 87.1%, 68.1% and 59.5% respectively, which were significantly higher than those in the rituximab-free treatment group (66.6%, 51.5% and 31.7%, respectively). The difference was statistically significant (all P<0.05). Among patients treated with rituximab, the complete remission rates (70.8% and 77.8%) of R-HyperCVAD/MA and VcR-CAP regimens were higher than those of R-CHOP regimen (39.0%, both P<0.05). However, there was no significant difference in the overall response rate, overall survival rate and progression-free survival rate (all P>0.05). Univariate analysis showed that age, Ki-67 index, B symptoms, bone marrow invasion, platelet count, LDH, β(2)-MG and MIPI scores were associated with overall survival (all P<0.05). Multivariate analysis showed that age (HR=4.940, 95% CI: 2.347 to 10.397), B symptom (HR=2.900, 95% CI: 1.517-5.544), β(2)-MG (HR=2.945, 95% CI: 1.656-5.238), Ki-67 index (HR=4.915, 95% CI: 2.554-9.456) and treatment with rituximab-containing regimen (HR=2.450, 95% CI: 1.352-4.440) were independent factors for OS. Conclusions: Most patients with MCL were older adults and usually had bone marrow involvement and spleen involvement. Rituximab combined with chemotherapy (especially R-HyprCVAD/MA and VcR-CAP) had better clinical efficacy than conventional chemotherapy.
目的：探讨套细胞淋巴瘤(MCL)的临床特征、疗效和预后影响因素。 方法：回顾性分析140例MCL患者的临床特征和不同治疗方案的疗效，并进行预后影响因素分析。 结果： 140例患者中位年龄59岁，男女之比为6∶1。Ann-Arbor分期Ⅲ～Ⅳ期134例(95.7%)，伴有B症状37例(26.4%)，骨髓受累61例(43.6%)，脾脏肿大38例(27.1%)。含利妥昔单抗方案治疗组总缓解率(ORR)、3年生存率和无进展生存率分别为87.1%、68.1%和59.5%，明显高于不含利妥昔单抗方案治疗组(分别为66.6%、51.5%和31.7%)，差异有统计学意义(均P<0.05)。在含利妥昔单抗方案治疗的患者中，R-HyperCVAD/MA方案组和VcR-CAP方案组的完全缓解率(分别为70.8%和77.8%)高于R-CHOP方案组(39.0%，均P<0.05)，但ORR、总生存率和无进展生存率差异无统计学意义(均P>0.05)。单因素分析结果显示，年龄、Ki-67指数、有无B症状、骨髓侵犯情况、血小板计数、乳酸脱氢酶(LDH)、β(2)-微球蛋白(β(2)-MG)、套细胞淋巴瘤国际预后指数(MIPI)评分与患者的总生存有关(均P<0.05)。多因素分析结果显示，年龄(HR＝4.940，95%CI：2.347～10.397)、B症状(HR＝2.900，95%CI：1.517～5.544)、β(2)-MG(HR＝2.945，95%CI：1.656～5.238)、Ki-67指数(HR＝4.915，95%CI：2.554～9.456)、是否采用含利妥昔单抗方案治疗(HR＝2.450，95%CI：1.352～4.440)是患者预后的独立影响因素。 结论： MCL高发于老年男性，Ⅲ～Ⅳ期居多，骨髓和脾脏受累较常见。利妥昔单抗联合化疗，尤其是R-HyperCVAD/MA方案和VcR-CAP方案，治疗MCL有较好的疗效。.
Keywords: Curative effect; Lymphoma, mantle cell; Prognosis; Rituximab.