Clinical Analysis Of 69 Cases Of T-cell Non-Hodgkin Lymphoma

Background: T-cell non-Hodgkin lymphoma (T-NHL) is a complex and heterogeneous group of malignancies characterized as lymphoproliferative disorders. The classifications and clinical manifestations of T-NHLs are both complicated. Recently, the incidence of T-NHLs is increased gradually. T-NHLs are more invasive and have worse prognosis than B-cell lymphomas, except a few subtypes. The remission rate of T-NHLs is low with the treatment of conventional combination chemotherapy including category of anthracene nucleus. There are no effective therapeutic methods used in T-NHLs, comparing with those in B-cell lymphomas.Object: Study the incidence, major patho-types, clinical features, and prognosis of T-NHLs, in order to search for the ways of early discovery, early diagnosis, and early treatment of T-NHLs.Methods: 69 patients with T-NHLs treated from October 2003 to October 2005 in First Affiliated Hospital, College of Medicine, Zhejiang University, were enrolled and analyzed retrospectively.Results: T-NHL represents approximately 21.63% of all NHLs. It usually affects male adult patients, at a median age of 48 years (range 12-80 years). The most common subtype is peripheral T-cell lymphoma, unspecified (PTCL-u), which accounted for 62.32% of all T-NHLs. Next is nasal-type T-cell and extranodal NK/T-cell lymphoma. The incidences of nodal and extranodal lymphomas are close. The clinical courses of T-NHLs are widely difference, a few days to several years, and the clinical manifestations of T-NHLs are complex. Patients of T-NHLs usually manifested as fever and lymphadenectasis without pain. 69.09% of patients presented with stage III or IV diseases. The prognosis of T-NHLs is bad, except a few subtypes, especially for patients of PTCL-u. 25.45% patients of all T-NHLs and more than one third patients of PTCL-u were dead in first month after diagnosis.Conclusions: The incidence of T-NHL is high, and the major subtype of it is PTCL-u. The clinical course and clinical manifestation of T-NHLs are widely different, and it is difficult to diagnose. It usually combined with extranodal tissues involving, especially with bone marrow infiltration. The therapeutic effect of T-NHL with conventional combination chemotherapy is not fine, for quickly progress. The prognosis is closely correlated with pathologic subtypes and clinical features. The death rate is obviously increased in patients with following characters: the patho-type is PTCL-u, stage IV, companied with whole blood reduce or hepatic dysfunction.