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弥漫大B细胞淋巴瘤

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维基百科,自由的百科全书
弥漫大B细胞淋巴瘤
类型B细胞淋巴瘤aggressive B-cell non-Hodgkin lymphoma[*]
分类和外部资源
医学专科肿瘤学
ICD-112A81
ICD-O英语International Classification of Diseases for OncologyM9680/3
eMedicine202969
MeSHD016403
Orphanet544
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弥漫大B细胞淋巴瘤Diffuse large B-cell lymphoma DLBL or DLBCL)是一种常见的恶性淋巴瘤。占成人淋巴瘤患者近40%。[1]

分型

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根据其基因活性,DLBL可分为2种[2]或3种[3]主要亚型:

  • 活化B细胞淋巴瘤(ABC-DLBCL)
  • 生发中心B细胞淋巴瘤(GCB-DLBCL)
  • 原发纵隔大B细胞淋巴瘤(PMBL)

治疗

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标准化疗方案为CHOP方案。改良的R-CHOP方案(利妥昔单抗加环磷酰胺、长春新碱、多柔比星和泼尼松)可以改善生存率[4],尤其是对于老年人。[2]但许多患者通过化学免疫治疗获得持久缓解,但高达50%的患者最终患有复发或难治性(R/R)疾病[5],进行二、三线治疗。

预后

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生发中心亚型的预后最好,5年生存率达60%。[2]

参考文献

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  1. ^ Pathobiology of the aggressive and highly aggressive non-Hodgkin's lymphomas. [2022-06-25]. (原始内容存档于2008-01-21). 
  2. ^ 2.0 2.1 2.2 Turgeon, Mary Louise. Clinical hematology: theory and procedures. Hagerstown, MD: Lippincott Williams & Wilkins. 2005: 285–286. ISBN 0-7817-5007-5. 
  3. ^ Lenz G; Wright GW; Emre NC; et al. Molecular subtypes of diffuse large B-cell lymphoma arise by distinct genetic pathways. Proc. Natl. Acad. Sci. U.S.A. September 2008, 105 (36): 13520–5. PMID 18765795. doi:10.1073/pnas.0804295105. 
  4. ^ Sehn LH; Berry B; Chhanabhai M; et al. The revised International Prognostic Index (R-IPI) is a better predictor of outcome than the standard IPI for patients with diffuse large B-cell lymphoma treated with R-CHOP. Blood. March 2007, 109 (5): 1857–61. PMID 17105812. doi:10.1182/blood-2006-08-038257. [永久失效链接]
  5. ^ Crump, Michael; Neelapu, Sattva S.; Farooq, Umar; Van Den Neste, Eric; Kuruvilla, John; Westin, Jason; Link, Brian K.; Hay, Annette; Cerhan, James R.; Zhu, Liting; Boussetta, Sami. Outcomes in refractory diffuse large B-cell lymphoma: results from the international SCHOLAR-1 study. Blood. 2017-10-19, 130 (16) [2024-03-12]. ISSN 0006-4971. PMC 5649550可免费查阅. PMID 28774879. doi:10.1182/blood-2017-03-769620. (原始内容存档于2024-06-05) (英语).