The Clinical Analysis Of Angioimmunoblastic T-cell Lymphoma

Angioimmunoblastic T-cell lymphoma (AITL) is currently classified as a subtype of peripheral T-cell lymphoma (PTL), and characterized by systemic disease, a polymorphous infiltrate primarily invoving lymoh nodes, with prominent proliferation of high endothelial venules amd follicular dendritic cells. AITL is rare accounting for approximately 1-2% of all non-Hodgkin lymphomas. This disease is seen mainly in eldly adults, and the patients always present with fever, weight loss, pruritus, generalized lymphadeno-pathy, and often hepatosplenomegaly and skin rash. Due to the rarity of the disease, thera have been relatively little data concerning it and high misdiagnosis rate. We studied the clinical and laboratory feature of 16 AITL patients compared with 54 other NHL patients by retrospective analysis.Objective:To summarize the clinical feature of AITL, and get more data concerning the impact of clinical and laboratory feature of AITL.Methods: Records of 16 AITL patients and 54 other NHL patients was diagnosed at the hospitals attached to Jilin University, from March 1999 to March 2009 were reviewed. All patients were diagnosed through organize biopsy, Staging and Grouping of lymphomas is according to Ann Arbor Stage. Compared commom condition, clinical manifestation and laboratory examination with other NHL patients. Measurement data and enumeration data were compared with t test andΧ2 test, if p<0.05, the difference was significant.Results:1) Of the 16 AITL patients, the median age is 52.5 years, the average age is 49.9±15.1 years; there were 8 males and 8 females, the sex ratio is 1:1。2) 16 AITL patients all presented generalized lymphadeno- pathy, and all or most of the lymph nodes were involved, 8 patients presented skin rash, 8 patients had serous cavity effusion, the rate of splenomegaly is 68.75%, and incidence of these symptoms is higher than other NHL patients (p<0.05). There have no significant difference between AITL and other NHL patients on the incidence of hepatomegaly,fever and weight loss. 7 (43.7%)patients have drug allergic history and 5(31.3%) patients have autoimmune disease, the incidence is higher than other NHL patients(p<0.05).3) Laboratory examination: 43.75% of AITL patients presented hypereosinophilia, significant higher than other NHL patients (p<0.05). Serology test: The AITL patients had high globin level, the average level is 40.7±14.9g/l, significant higher than other NHL. Serum Protein Electrophoresis of 14 AITL patients prompted all patients have hypergammaglobulinemia, significant higher than other NHL patients. And there is no monoclonal M peak in the serum protein electrophoresis. Theβ2-MG, LDH and ESR level of two groups both had different degree rise, but the diffiernce have no significance.4) The AITL :68.7% patients presented more than 3 aforementioned symptoms or examinations, is significant higher than other NHL patients.5) Treatment: 14 AITL patients got chemotherapy with CHOP or like-CHOP regiment, the CR rate is 14.3% and PR rate is 50%.Conclusion:1) AITL is seen mainly in eldly adults, with an equal male: female ratio, pursues an aggressive clinical course.2) AITL is characterized with higer incidence of generalized lymphadenopathy, skin rash, serous cavity effusion and splenomegaly, and generalized lymphadenopathy always involve all or most of the lymph nodes.3) Hypereosinophilia and multiclonal hypergammaglobuli- nemia are specific of AITL.4) Althoght the aforementioned syndrome and examination are not specific of AITL,but their association appears to be very suggestive of the disease.