关键词: B细胞非霍奇金淋巴瘤, 间质性肺炎, 利妥昔单抗, T淋巴细胞亚群

Abstract: Background and purpose: As rituximab was widely applied in the treatment of B-cell non- Hodgkin’s lymphoma (NHL), rituximab-induced interstitial pneumonia (IP) attracted more and more attention for its diagnostic and therapeutic particularity. We aimed to identify the risk factors and clinical features of interstitial pneumonia (IP) in B-cell lymphoma patients who were treated with “rituximab+cyclophosphamide+adriamycin+vincris tine+prednisone (R-CHOP)” regimen, in order to analysis method of early diagnosis and effective treatment. Methods: Retrospective analysis was done on 103 newly diagnosed B-cell non-Hodgkin’s lymphoma patients in our department. Among them, 61 patients were treated with R-CHOP regimen and the other 42 patients were treated with CHOP regimen. Results: Interstitial pneumonia tended to occur more frequently in R-CHOP group than CHOP alone group (14.8% vs 2.4%, Ρ<0.05). Patients with smoking (38.1% vs 2.5%) and B symptoms (33.3% vs 7.0%) were at greater risk of IP treated with R-CHOP regimen (Ρ<0.05). The most common symptoms were fever, dyspnoea and dry cough. Chest CT is the primary diagnostic basis. All the IP patients were treated with corticosteroids combined with antibiotics. The symptoms of 9 cases improved, while 1 case died with severe pulmonary mixed infections and complication. There was no significant difference of T lymphocyte subsets between the groups of patients with IP and without IP treated by R-CHOP chemotherapy program. Among the patients with IP, the level of CD4 cells and the ratio of CD4 cells to CD8 cells didn’t decrease significantly (Ρ>0.05), while that of CD8 cells increased significantly (before chemotherapy 37.11±8.87, after chemotherapy 42.44±6.52, Ρ<0.05) after chemotherapy. Conclusion: Beware of interstitial pneumonia in B-cell lymphoma patients treated with R-CHOP regimen, especially those with smoking and B symptoms. Early diagnosis and corticosteroids therapy can effectively relieve the patient’s symptoms. Detection of peripheral blood T-cell subsets during chemotherapy might have certain clinical significance.

Key words: B cell non-Hodgkin’s lymphoma, Interstitial pneumonia, Rituximab, T lymphocyte subsets