外周t细胞淋巴瘤讲稿修改

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1、外周T细胞淋巴瘤治疗进展中国医学科学院肿瘤医院内科周生余typhoonwho@hotmail.com2011.8.@CCMOBeijingCancerHospitalofCAMS&PUMC外周T/NK细胞淋巴瘤定义一组源于胸腺后成熟T淋巴细胞或自然杀伤(naturalkiller，NK)细胞的淋巴系统恶性肿瘤，其生物学行为及临床表现具有明显异质性。WHO成熟T/NK细胞肿瘤分类(2008)T-cellprolymphocyticleukemiaT-celllargegranularlymphocyticleukemiaChroniclymphoproliferativ

2、eNKcellsAggressiveNK-cellleukemiaAdultT-celllymphoma/leukemiaSystemicEBV-positiveT-celllymphomaExtranodalNK/T-celllymphoma,nasaltypeEnteropathy-typeintestinalT-celllymphomaHepatosplenicT-celllymphomaAngioimmunoblasticT-celllymphomaAnaplasticlarge-celllymphoma,ALKpositiveAnaplasticlarge-

3、celllymphoma,ALKnegativePeripheralT-celllymphoma,NOSMycosisfungoidesSézarysyndromePrimarycutaneousCD30+lymphoproliferativePrimarycutaneousanaplasticlargecellLymphomatoidpapulosisBorderlinelesionsSubcutaneouspanniculitis-likeTcellPrimarycutaneousgamma-deltaTcellHydroavacciniformelymphoma

4、PrimarycutaneousaggressiveepidermotropicCD8+cytotoxicTcellPrimarycutaneoussmall/mediumCD4+T-celllymphoma(provisional)SwerdlowSH,etal.WHOclassificationoftumoursofthehaematopoleticandlymphoidtissues.2008.1314例T细胞淋巴瘤，各亚型分布LosAngeles,CA.October4,2008外周T细胞淋巴瘤各亚型分布外周T细胞淋巴瘤各亚型生物学异质性PTCL不同亚型疾病异

5、质性CHOP治疗PTCL不同亚型生存资料如何改善PTCL预后？传统治疗的探索剂量强度与密集方案高剂量化疗联合造血干细胞移植新药的开发与应用基于疾病异质性的特色治疗PTCL生物学本质、疾病特点、以及各亚型异质性认识?!开发应用于T细胞淋巴瘤的新药开发应用于T细胞淋巴瘤的新药吉西他滨治疗PTCLStudyRegimenNORRSallahetalGemcitabinemonotherapy1060%ZinzanietalPhaseIIGemcitabinemonotherapy1369%RoyalMarsdenPhaseIIGEM-P1669%SpenceretalPil

6、otstudyVGF1070%KimetalPilotstudyCHOP-EG2677%CHOP-EG=CHOP-etoposide,gemcitabine;GEM-P=gemcitabine,cisplatin,methylprednisolone;VGF=vinorelbine,gemcitabine,filgrastim.Foss.2009ASCOEducationalBook.Alexandria,VA:AmericanSocietyofClinicalOncology.2009;480;Pro.2009ASCOEducationalBook.Alexandr

7、ia,VA:AmericanSocietyofClinicalOncology.2009;486;Sallah.BrJHaematol.2001;113:185;Zinzani.AnnOncol.1998;9:1351;Arkenau.Haematologica.2007;92:271;Spencer.InternMedJ.2007;37:760;Kim.CancerChemotherPharmacol.2006;58:35.PhaseⅡStudyofBendamustineinRelapsed/RefractoryT-CellLymphomaPre