弥漫大B细胞淋巴瘤
外观
弥漫大B细胞淋巴瘤 | |
---|---|
类型 | B細胞淋巴瘤、aggressive B-cell non-Hodgkin lymphoma[*] |
分类和外部资源 | |
醫學專科 | 肿瘤学 |
ICD-11 | 2A81 |
ICD-O | M9680/3 |
eMedicine | 202969 |
MeSH | D016403 |
Orphanet | 544 |
弥漫大B细胞淋巴瘤(Diffuse large B-cell lymphoma DLBL or DLBCL)是一种常见的恶性淋巴瘤。占成人淋巴瘤患者近40%。[1]
分型
[编辑]根据其基因活性,DLBL可分为2种[2]或3种[3]主要亚型:
- 活化B细胞淋巴瘤(ABC-DLBCL)
- 生發中心B细胞淋巴瘤(GCB-DLBCL)
- 原发纵隔大B细胞淋巴瘤(PMBL)
治疗
[编辑]标准化疗方案为CHOP方案。改良的R-CHOP方案(利妥昔单抗加环磷酰胺、长春新碱、多柔比星和泼尼松)可以改善生存率[4],尤其是对于老年人。[2]但许多患者通过化学免疫治疗获得持久缓解,但高达50%的患者最终患有复发或难治性(R/R)疾病[5],进行二、三线治疗。
预后
[编辑]生发中心亚型的预后最好,5年生存率达60%。[2]
参考文献
[编辑]- ^ Pathobiology of the aggressive and highly aggressive non-Hodgkin's lymphomas. [2022-06-25]. (原始内容存档于2008-01-21).
- ^ 2.0 2.1 2.2 Turgeon, Mary Louise. Clinical hematology: theory and procedures. Hagerstown, MD: Lippincott Williams & Wilkins. 2005: 285–286. ISBN 0-7817-5007-5.
- ^ Lenz G; Wright GW; Emre NC; et al. Molecular subtypes of diffuse large B-cell lymphoma arise by distinct genetic pathways. Proc. Natl. Acad. Sci. U.S.A. September 2008, 105 (36): 13520–5. PMID 18765795. doi:10.1073/pnas.0804295105.
- ^ Sehn LH; Berry B; Chhanabhai M; et al. The revised International Prognostic Index (R-IPI) is a better predictor of outcome than the standard IPI for patients with diffuse large B-cell lymphoma treated with R-CHOP. Blood. March 2007, 109 (5): 1857–61. PMID 17105812. doi:10.1182/blood-2006-08-038257.[永久失效連結]
- ^ Crump, Michael; Neelapu, Sattva S.; Farooq, Umar; Van Den Neste, Eric; Kuruvilla, John; Westin, Jason; Link, Brian K.; Hay, Annette; Cerhan, James R.; Zhu, Liting; Boussetta, Sami. Outcomes in refractory diffuse large B-cell lymphoma: results from the international SCHOLAR-1 study. Blood. 2017-10-19, 130 (16) [2024-03-12]. ISSN 0006-4971. PMC 5649550 . PMID 28774879. doi:10.1182/blood-2017-03-769620. (原始内容存档于2024-06-05) (英语).