恶性血液病淋巴瘤(英文).ppt

Clinical application of Rituximab Combined with CHOP treatment of NHL week 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 Rituximab 375mg/m2 CHOP courses Maintained 1/2 M X4 times Treatment of NHL Peripheral Blood Stem Cell Transplantation (PBSCT) HD stage Ⅲ,Ⅳ NHL stage Ⅲ,Ⅳ Relapse after first CR or CR after salvage therapy Support therapy Side effect of chemotherapy Support therapy Leukopenia antibiotic, G-CSF Thrombocytopenia platelet infusion, TPO Anemia RBC infusion, EPO Immunosuppression thymic peptid Chinese traditional medicine  IPI: Overall Survival by Risk Strata Adapted from Shipp. N Engl J Med. 1993;329:987. 100 75 50 25 0 0 2 4 6 8 10 H HI LI L Patients (%) Year Age-Adjusted IPI: Overall Survival by Risk Strata HI H LI L 100 75 50 25 0 0 2 4 6 8 10 Patients (%) Year Adapted from Shipp. N Engl J Med. 1993;329:987. DLCL: Overall Survival Year Adapted from Armitage and Weisenburger. J Clin Oncol. 1998;16:2780. Patients (%) 100 60 40 20 0 0 2 5 6 7 8 3 4 1 80 IPI 0-1 IPI 2-3 IPI 4-5 P0.001 Conclusion Pathological classification: HD or NHL Clinical Manifestations: HD or NHL Diagnosis Clinical staging: Ann Arbor Treatment: HD and NHL Case Anlysis 45 years old male, with cervical painless lymph node enlargement, fatigue, weight loss and no fever; WBC 7.5×109/L, Hb 80g/L, PLT234×1012/L ; N:48%, L:50%, E2%; What should you do next? How to make precise diagnosis? How to treat the patient? * To identify prognostic factors for survival, an international study involving 2000 patients with aggressive NHL was conducted between the year