CSMO 2014 :NK/T细胞淋巴瘤诊治新进展

2014-07-09 中山大学肿瘤防治中心 黄慧强 白冰 医学论坛网

在7月4日的第八届中国肿瘤内科大会会上,中山大学肿瘤防治中心的黄慧强教授作了“NK/T细胞淋巴瘤诊治新进展---中国医生的贡献”的主题报告。   结外NK/T细胞淋巴瘤(extranodal natural/killer T-cell lymphoma, ENKTL)属于结外非霍奇金淋巴瘤 (NHL)的一种少见特殊类型,ENKTL亚洲多

在7月4日的第八届中国肿瘤内科大会会上,中山大学肿瘤防治中心的黄慧强教授作了“NK/T细胞淋巴瘤诊治新进展---中国医生的贡献”的主题报告。  

结外NK/T细胞淋巴瘤(extranodal natural/killer T-cell lymphoma, ENKTL)属于结外非霍奇金淋巴瘤 (NHL)的一种少见特殊类型,ENKTL亚洲多见,尤以中国,在所有淋巴瘤亚型中,比例可达6%,,而在欧美国家少见,其好发于中年男性,中位年龄45岁。ENKTL预后不佳,经典的国际预后指数 (International Prognostic Index,IPI)可用于ENKTL的预后评估。新的预后指标(Korean Prognostic Index,KPI) 基于临床分期、区域淋巴结受累、LDH和B症状而设计。与IPI相比,KPI能够更好的区分不同危险度的患者,并具有更合理、均匀的患者分布。

ENKTL恶性度高,对常规化疗敏感度相对较低,预后不佳。早期疾病以放射治疗为主,部分患者可以达到长期无病生存,中晚期疾病及复发难治性疾病采用以化疗为主的综合治疗,预后较差。而我国学者在ENKTL的综合治疗上做出了大量的努力,也获得了一定的成就,部分成就也得到了国际同仁的认可。

尽管ENKTL侵袭性强,预后不佳。迄今仍未有标准的治疗方法,但近年我国学者做出了大量的贡献,NK/T淋巴瘤的治疗效果有了比较明显的提高。对于早期局部的ENKTL,采用局部放疗为主联合诱导化疗效果较好,晚期患者以全身化疗为主,含L-ASP的化疗方案越来越受到重视,笔者认为像PEG-ASP(培门冬酶)联合Gemox这样简单有效的方案,很值得推广。自体造血干细胞移植巩固治疗有助改善高危的初治患者及对化疗敏感的复发患者远期生存,而靶向治疗和其他治疗值得我们共同努力,进一步探索。

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    2015-05-03 liuhuangbo
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