瀰漫大B細胞淋巴瘤
外觀
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瀰漫大B細胞淋巴瘤 | |
---|---|
類型 | B細胞淋巴瘤、aggressive B-cell non-Hodgkin lymphoma[*] |
分類和外部資源 | |
醫學專科 | 腫瘤學 |
ICD-11 | 2A81 |
ICD-O | M9680/3 |
eMedicine | 202969 |
MeSH | D016403 |
Orphanet | 544 |
瀰漫大B細胞淋巴瘤(Diffuse large B-cell lymphoma DLBL or DLBCL)是一種常見的惡性淋巴瘤。占成人淋巴瘤患者近40%。[1]
分型
[編輯]根據其基因活性,DLBL可分為2種[2]或3種[3]主要亞型:
- 活化B細胞淋巴瘤(ABC-DLBCL)
- 生發中心B細胞淋巴瘤(GCB-DLBCL)
- 原發縱隔大B細胞淋巴瘤(PMBL)
治療
[編輯]標準化療方案為CHOP方案。改良的R-CHOP方案(利妥昔單抗加環磷酰胺、長春新鹼、多柔比星和潑尼松)可以改善生存率[4],尤其是對於老年人。[2]但許多患者通過化學免疫治療獲得持久緩解,但高達50%的患者最終患有復發或難治性(R/R)疾病[5],進行二、三線治療。
預後
[編輯]生發中心亞型的預後最好,5年生存率達60%。[2]
參考文獻
[編輯]- ^ Pathobiology of the aggressive and highly aggressive non-Hodgkin's lymphomas. [2022-06-25]. (原始內容存檔於2008-01-21).
- ^ 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.
- ^ 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.
- ^ 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.[永久失效連結]
- ^ 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). ISSN 0006-4971. PMC 5649550
. PMID 28774879. doi:10.1182/blood-2017-03-769620 (英語).
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