Clinical Research Of Hodgkin Lymphoma And Radiation And Chemotherapy Effects On Hematopoietic And Immunologic Function In Mice

Objective To investigate the clinical characteristics、pathologic types、therapeutic method and prognostic factors for of Hodgkin Lymphoma(HL). And through the animal experiments to explore the influence of TBI in the conditioning regimen for autologous stem cell transplantation effects on hematopoietic and immunologic function.Methods1^Clinical data of62HL patients were analyzed retrospectively,so did treatment outcome and prognostic factors.2、Clinical data of62HL patients were analyzed retrospectively, so did clinical features and treatment outcome.3、With different doses of radiation and chemotherapy treatment in mice, hematopoietic and immunologic function were observed at different time pointsResults1、62HL patients accounted for5.66%of the total number of newly diagnosed patients with lymphoma (45/795) in the period, the ratio of sex was:2.1:1(male:female). All the pathological type were classical Hodgkin Lymphoma(cHL). Nodular sclerosis type (NS)(53.23%) and mixed cell type (MC)(30.65%) are major in this group, accounted for83.87%(52/62). Among of the56cases who were followed up, The median overall survival time was45(8-184) months.the total effective rate was92.9%, the2,3and5year overall survival (OS) rates were97.7%、92.2%、80.5%respectively. Analysing of the prognostic factors indicated that the level of spleen (P=0.042).outside the junction involvement (P=0.010) and GHSG risk factors (P=0.002) were prognostic factor with statistic significance.2、of the62HL patients,12patients (19.35%) were refractory/refractory HL. Pathologic type (P=0.026)、Lymph node area≥3(P=0.030) and large mass (P=0.006) were important relapsed/refractory factors.The median overall survival time of relapsed/refractory HL was69.5(27-129) months, The5year overall survival (OS) in relapsed/refractory HL and others were66.7%and88.8%respectively.The5year event-free survival (EFS) in relapsed/refractory HL were52.4%and others87.9%respectively.the5year EFS of relapsed patients was lower than others (p=0.006).3、Side-effects of radiation and chemotherapy compared with mice model show that:(1) Each dose group showed different of damage to hematopoietic. White blood cells were decreased within4days. Chemotherapy group recovere d quickly. Radiation group recovered slower;6Gy group and8Gy group fail ed to recover.Meanwhile HGB and PLT after Radiation were increased.(2)Im munologic function was decreased between2Gy and200mg/kg. Radiation gro up is larger than chemotherapy group effect on the immune function.The Radia tion and chemotherapy compared with CD4+、CD8+and Natural Kill cell, the re were significant differences (P<0.05). CD8+T cell is the sensitivity to irra diation in the immune system. No obvious change in NK cells in the radiation group.(3)2Gy radiation mice when WBC count were reestorery,the T cell func tion ia still in a low value.Conclusion1、(1)1lodgkin lymphoma is more common in young men. Peak onset age of30years old, and no bimodal age distribution was observed.(2)Lymphnodes in neck were most likely involved.second were mediastinum and armpit lymph nodes.(3)HL is one of the curable malignant tumors.(4)ESR、GHSG scoring system and spleen involvement can predict the prognosis in HL patients.2、(1) refractory/refractory HL rate was19.35%.Pathologic type、Lymph node area≥3and large mass were closely related with refractory/refractory HL.(2) Recurrence in the short-term (<1year) rate was36.36%, it is the independent prognostic factor for patients with relapsed/refractory HL.3、(1) Side-effects of radiation and chemotherapy compared with mice mo del.Each dose group showed different of damage to hematopoietic. the radioth erapy appeared early hematopoietic injury.White blood cells were decreased wit hin4days. Chemotherapy group recovered quickly of6-8d, Radiation were increased recovery rate slower to27d,6gy above can’t restore automatically.(3) Radiation group is larger than chemotherapy group effect on the immune function.CD8+T cell is the sensitivity to irradiation in the immune function, No obvious change in NK cells in the radiation group.white cells of irradiation group mice were restored, the T cell population proportion is still relatively low.