| Objective:To investigate the clinical and pathological characteristics of patients with glandular Lymphoma and to analyze its therapeutic efficacy and prognostic factors.Methods:Retrospective analysis The clinical data of 105 newly diagnosed glandular lymphoma patients who first diagnosed in the Cancer Center,First Hospital of Jilin University from January 2008 to December 2015.Results:1.Glandular Lymphoma accounted for 9.4% of lymphoma over the same period(105/1115).There were 46 cases of primary glandular lymphoma,accounting for 43.8%,The ratio of male to female was 0.98:1.The median age of these patients was 57 years old(17~80).Among 105 cases of glandular lymphomas,53.3%(56/105)of them were Ann Arbor stage ? / ? and 46.7%were stage ? / ?,70.5% had no B symptoms,while 64.8% were with normal lactate dehydrogenase(LDH),but 79.0%(83/105)showed abnormal higher lever of ?2 microglobulin.Among 102 cases of NHL,IPI score was mainly 0~2,accounting for 68.6%(70/102).2.The mainly incidence anatomical locations were head and neck gland,accounting for 68.6%.The pathological type was mainly non-Hodgkin's Lymphoma(NHL),accounting for 97.1%(102/105).The most common pathology type was DLBCL,accounting for 71.6%(73/102).3.In 105 cases of glandular lymphoma,62 cases accepted ?4 courses therapy,and the ORR was 77.4%.Among them,the ORR of B-cell lymphoma was 81.0%(47/58).Among the 58 cases B cell Lymphoma with more than 4therapeutic,ORR was 93.1% in targeted therapy group(with Rituximab),which was higher than 69.0% in chemotherapy alone group(without Rituximab)(P=0.019).As of December 2016,the median follow-up time was33.5 months.10 patients were lost to follow-up.Survival rate was 71.6% in 95 patients with sustainable follow-up(68/95).Survival rate of the patients accept more than 4 cases was 79.3%,significantly higher than 55.2% of the ones with1 ~ 3 courses(P= 0.019).To analyzed the survival of patients who were followed up more than 2 years,OS of whose therapeutic courses ?4 was90.7%(49/54),significantly higher than the 1~3 courses' 64.5%(20/31)(P=0.003).The actual median OS was not achieved in these patients,but the average survival time of the formers was longer than the later ones(P=0.009).4.Univariate analysis(Log-rank test)showed that more than 65 years old(P= 0.013),systemic B symptoms(P= 0.043),elevated LDH levels(P= 0.002),IPI score> 2(P = 0.001),stage ? / ?(P = 0.001)were correlated with OS negatively.Multivariate analysis(COX regression)showed that stage was an independent OS prognostic factor for glandular lymphoma.Conclusions:1.The patients with glandular lymphoma were young(age ? 65 yearsaccounted for 78.1%),early stage(I/II stage accounted for 53.3%),mild symptoms(70.5% patients had no systemic B symptoms).2.The anatomic site were mainly head and neck gland(68.6%),and tonsils(43.8%)were in the majority.3.Glandular lymphoma was dominated by NHL,especially DLBCL(71.6% of total gland lymphoma).4.The B-cell glandular lymphoma had a better curative effect based on ?4 courses standardized chemotherapy in targeted therapy group(with Rituximab).5.Univariate analysis(Log-rank test)showed more than 65 years old,systemic B symptoms,elevated LDH levels,IPI score> 2,stage ? / ?were associated with poorer OS.Multivariate analysis(COX regression model)showed that stage was independent prognostic factor for glandular lymphoma OS. |
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