| An analysis of clinical charicteristics and effects of 408 patients with malignant lymphomaObjective:Study the onset of clinical features,laboratory results,therapeutic factors on the lymphoma in our department, to provide a help for the clinical diagnosis and reasonable treatment of malignant lymphoma.Methods:Collecting the clinical data, laboratory results and treatment effects of hospitalized patients in our hematology department,June 1999-June 2009. Using STATA 10.0 software for data analysis.Results:In the 408 cases treated in our department between June 1999 to June 2009,27 were Hodgkin's lymphoma (HL) and 381 were Non-Hodgkin's lymphoma(NHL). NHL was 14 times HL.298 cases were NHL-B cell lymphoma and 83 cases were NHL-T/NK cell lymphoma.263 were male and 145 were female. The overall male to female ratio was 1.8:1. The mean age was 51 years old (range 12-86) and the median age was 53. The first five common onset symptoms were superfical lymph nodes,deep lesions,fever,weight loss and limb numbness,pain,paresthesia. NHL-T/NK had more fever symptoms than HL,NHL-B at the onset(P<0.001). In the 408 cases,118 cases(28.92%) were nodal lymphoma,290 cases(71.10%) were extranodal. In these extranodal ones, the first five onset organs or tissues were central nervous system,stomach, skin, Waldeyer ring(tonsils and nasopharyngeal region), intestines. Analysising the onset symptoms and some laboratory examination results of the 366 non-primary central nervous system lymphoma(256 cases were NHL-B,83 cases were NHL-T/NK,27 cases were HL), we revealed NHL-T/NK were more often associated with B symptoms (P<0.001,χ2=19.274), three lines decreased(P<0.001,χ2=19.839). Camparing the 366 Non-PCNSL and the 42 PCNSL, we revealed Non-PCNSL were more often associated with B symptoms (P＜0.001,χ2=19.423), liver damage(P=0.009,χ2=6.908),β2-MG increased (P＜0.001,χ2=14.421).In the 342 cases patients could be traced to the effect,71 cases were CR(20.76%),95 cases were PR(27.78%), and 166 cases were effective(48.54%). In the 255 NHL-B cases, the CR rate of the PCNSL group was 24.32%,and the total effective rate was 40.54%. The CR rate of the non-PCNSL group was 20.64%,and the total effective rate was 50.46%. Patients had a poor efficacy with central onset(P=0.010,χ2=11.424). In the 42 patients using CHOPE, the NHL-B group had a CR rate 16%, a total effective rate 48%; the NHL-T/NK had a CR rate 17.65%, a total effective rate 35.29%.The NHL-B group had a better effect than the NHL-T/NK group with CHOPE(P=0.001,χ2=15.712).In the 148 systemic NHL who associated with bone marrow cells in naive lymphoid(≤60-year-old), the group of 0.5%-0.9% immature lymphoid cells had a CR rate of 30.77%, a total effective rate of 80.77%. The group of 1.0%-1.4% had a CR rate of 27.91%, a total effective rate of 65.12%. The group of 1.5%-1.9% had a CR rate of 13.89%, a total effective rate of 36.11%. The group of 2.0%-4.9% had a CR rate of 16.28%,a total effective rate of 34.88%.With the proportion of micro-naive lymphoid cells increased, the complete rate of younger patients declined(P=0.004,χ2=24.596).In the 150 systemic NHL-B who associated with bone marrow cells in naive lymphoid, the group of 0.5%-0.9% immature lymphoid cells had a CR rate of 33.33%, a total effective rate of 66.67%. The group of 1.0%-1.4% had a CR rate of 27.5%, a total effective rate of 65%. The group of 1.5-1.9% had a CR rate of 0%, a total effective rate of 34.62%.The group of 2.0%-4.9% had a CR rate of 17.54%,a total effective rate of 35.09%. With the proportion of micro-naive lymphoid cells incerased, the complete rate declined(P=0.001,χ2=26.901).Divided 111 NHL with the time to reach the CR/PR(1-3courses,3-6 courses,>6courses), and the bone marrow with newly diagnosed the proportion of immature lymphoid cells in accordance with 0.5%-0.9%,1.0%-1.4%,1.5%-1.9%,2.0%-4.9%. We could find significant difference (P=0.017,χ2=14.896),which means with the increase of the proportion of lymphoid cells, ones achieved CR/PR gradually extend the time.104 IV NHL patients according to the comparison group in the same way, we could also find the trend(P=0.018,χ2=14.804).In 320 NHL cases, initial serum LDH>300U/L group had a CR rate of 8.06%, a total effective rate of 24.19%; LDH≤300U/L group had a CR rate of 23.26%, a total effective rate of 53.88%. Patients with elevated LDH had a poor efficacy(P<0.001,χ2=19.833). Initial serumβ2-MG>2.5mg/L group had a CR rate of 8.72%, a total effective rate of 32.89%;β2-MG≤2.5mg/L group had a CR rate of 30.41%, a total effective rate of 61.4%. Patients with elevated (32-MG had a poor efficacy(P<0.001,χ2=33.801). The group of serum LDH andβ2-MG were high had a CR rate of 6.25%, a total effective rate of 15.63%. The group of high LDH and normalβ2-MG had a CR rate of 10%, a total effective rate of 33.33%. The group of normal LDH and highβ2-MG had a CR rate of 9.40%, a total effective rate of 37.61%. The group of normal LDH andβ2-MG had a CR rate of 34.75%, a total effective rate of 67.83%. Elevated LDH andβ2-MG are indicators of the efficacy (P＜0.001, χ2=60.680). And,the high LDH and normalβ2-MG group was no different from the group with normal LDH and highβ2-MG(P>0.05). The group with normal LDH and highβ2-MG was different from the group with normal LDH andβ2-MG (P<0.001,χ2=36.375). The group with high LDH andβ2-MG was different from the group with normal LDH andβ2-MG(P<0.001,χ2=3.936).LDH andβ2-MG test on the efficacy had a equal significance maybe. The statistics showed the normalβ2-MG group had a better efficacy than the high group of CHOP(P=0.002,χ2=16.168).The multivariate-factor, single-factor analysis of HL found no significant prognostic factors. The multivariate-factor analysis of NHL found no significant ones, but the single-factor regression analysis found the LDH,serumβ2-MG,CD10 different between stages (P all<0.05).Conclusion:The male to female ratio of lymphoma incidence, the average age of onset, the NHL proportion were the same as the domestic situation in the study. The proportion of extra-nodal lymphoma was high. The most common symptom was superficial lymph nodes, and the most common site was central nervous system, which were higher than the domestic situation. NHL-T/NK associated with B symptoms, three lines down more frequently. Non-PCNSL was more often associated with B symptoms,β2-MG increased, liver damage than PCNSL.At the first treatment, the overall chemotherapy response rate was 48.58%. PCNSL had a worse efficiency than non-PCNSL. IV NHL who with bone marrow involvement had a worse efficiency than those without. The higher proportion of immature lymphoid cells in the bone borrow,the lower the treatment efficiency was.In the proportion of 0.5%-1.9%, this trend also existed. Patients with high LDH,highβ2-MG had a bad efficiency. And the two markers were better than a single target detection in effect. The high serumβ2-MG ones were poor efficiency with CHOP. With the increase of the proportion of lymphoid cells in the bone marrow, NHL patients extended the time to achieve CR/PR, particularly in the IV cases.
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