b细胞淋巴瘤相关噬血细胞综合征的临床特征和预后:一项回顾性单中心研究

H. Hou, Xudong Zhang, Siyu Qian, Zeyuan Wang, M. Dong, Xiaojuan Zhang, X. Duan, Yue Zhang, Qing Wen, Jing-Ru Ge, Yaxin Lei, Mingzhi Zhang, Qingjiang Chen
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摘要

继发性噬血细胞综合征(HPS),又称噬细胞性淋巴组织细胞病(HLH),是由免疫系统继发性过度刺激引起的一种危及生命的综合征,即使经过适当治疗,死亡率也很高。HLH多由恶性肿瘤、感染或自身免疫性疾病引发,其中恶性相关噬血细胞综合征(malignant -Associated Hemophagocytic Syndrome, MAHS)在继发性HLH中所占比例最高(约48%),其中淋巴瘤相关噬血细胞综合征(Lymphoma Associated Hemophagocytic Syndrome, LAHS)最为常见[1-3]。在LAHS病例中,T/ nk细胞淋巴瘤比罕见的b细胞淋巴瘤[4]更为常见。b细胞LAHS (B-LAHS)主要在亚洲人群中被描述,但较大的集合是罕见的。HLH的早期临床表现是非特异性的,主要表现为持续发热、全血细胞减少和肝脾肿大,并伴有侵袭性疾病进展[5]。因此,早期诊断和立即引入适当的治疗对这些患者至关重要。
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Clinical Features and Prognosis of B-cell Lymphoma-associated Hemophagocytic Syndrome: A Retrospective Single Center Study
Secondary Hemophagocytic Syndrome (HPS), also known as Hemophagocytic Lymphohistocytosis (HLH), is a life-threatening syndrome caused by secondary overstimulation of the immune system, with a high mortality rate even after appropriate treatment. HLH is often triggered by malignancies, infections or autoimmune diseases with the Malignancy-Associated Hemophagocytic Syndrome (MAHS) accounting for the highest proportion of secondary HLH (about 48%), and Lymphoma Associated Hemophagocytic Syndrome (LAHS) being the most common [1–3]. Among the LAHS cases, T/NK-cell lymphoma is much more common than the rarely seen B-cell lymphoma [4]. B-cell LAHS (B-LAHS) is predominantly described in Asian populations but larger sets are rare. Early clinical manifestations of HLH are nonspecific, mostly manifesting in persistent fever, pancytopenia and hepatosplenomegaly with an aggressive disease progress [5]. Therefore, early diagnosis and immediate introduction of appropriate treatment are crucial for these patients.
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