弥漫大b，化疗已经结束，在放疗，求大神指教

青青子衿123

橙色雨丝 发表于 2020-9-5 16:00
一般来说大B巩固性放疗剂量是30-36Gy，18已经是太低了，目前情况也只能坚持做完吧，放疗断断续续的问题倒 ...

刚刚看到了您发的关于p53的帖子，也基本明白了p53的意义，放疗的剂量也是医生商量关于我骨髓抑制严重来制定的方案，应该也算量体裁衣了吧！感谢雨丝的回复，也谢谢您对淋巴瘤知识的普及，谢谢

yamazhaki2

青青子衿123 发表于 2020-9-5 12:39
不是，核磁提示只局部水肿信号，然后抗生素治疗没效果，最后决定活检

哦，谢谢，我右髋关节核磁都没见异常，但右髋关节到右半边臀部疼痛了一年多，无论站着坐着躺着都疼，也怕寒，休息后略有缓解，现在右膝也开始疼，不知道到底是什么原因，呜呜

青青子衿123

橙色雨丝 发表于 2020-9-5 15:24
生发中心型弥漫大B，病理上应该没有什么问题。个人认为四疗CR，应该接着再做两个周期的R-CHOP巩固。放疗虽 ...

@橙色雨丝，雨丝，请问我这个叫骨淋巴瘤吗？昨晚上了解到了这个词语，心里很忐忑，半夜睡不着，又找不出结果，所以问问你，麻烦空了回复一下我，谢谢了

橙色雨丝

青青子衿123 发表于 2020-9-6 04:56
@橙色雨丝，雨丝，请问我这个叫骨淋巴瘤吗？昨晚上了解到了这个词语，心里很忐忑，半夜睡不着，又找不出 ...

Primary Bone Lymphoma Exhibits a Favorable Prognosis and Distinct Gene Expression Signatures Resembling Diffuse Large B-Cell Lymphoma Derived From Centrocytes in the Germinal Center

Xin Li  1 , Zijun Y Xu-Monette, Shuhua Yi, Bouthaina S Dabaja, Ganiraju C Manyam, Jason Westin, Nathan Fowler, Roberto N Miranda, Mingzhi Zhang, Judith A Ferry, L Jeffrey Medeiros, Nancy L Harris, Ken H Young

PMID: 28817403  DOI: 10.1097/PAS.0000000000000923
Abstract

Primary bone (PB) diffuse large B-cell lymphoma (DLBCL) is rare and has a favorable prognosis, but the underlying biological mechanisms remain unknown. In this study we analyzed the clinicopathologic features of 160 patients with PB-DLBCL in comparison with 499 nonosseous DLBCL. Compared with patients with nonosseous DLBCL and secondary involvement of bone by DLBCL, PB-DLBCL patients less frequently had elderly age, B-symptoms, elevated serum lactate dehydrogenase levels, and high International Prognostic Index at diagnosis, more frequently had germinal center (GC) subtype (approximately 90%) and complete remission, and had significantly better survival. The 5-year progression-free and overall survival rates of PB-DLBCL patients were 80% and 93%, respectively, superior to both GC B-cell-like (GCB) and activated B cell-like subtypes of DLBCL. Further stratifying nonosseous DLBCL cell-of-origin subtypes by clinical factors showed that PB-DLBCL had similar survival rates as the centrocyte-origin (CC) subtype of DLBCL-GCB classified by the B-cell-associated gene signature algorithm. To better understand the favorable outcome of PB-DLBCL patients, gene expression profiling and microRNA profiling were performed in a small subset of PB-DLBCL. The gene expression profiles of PB-DLBCL resembled those of nonosseous DLBCL-GCB-CC, but were distinct from other DLBCL cell-of-origin especially the centroblast-origin (CB) subtype. Compared with DLBCL-GCB-CB, PB-DLBCL and DLBCL-GCB-CC also had much higher levels of miR-125a-3p, miR-34-3p, and miR-155-5p, and significantly lower levels of miR-17-5p and miR-17-3p. These results demonstrated that PB-DLBCL is clinically distinct, and the cell-of-origin of PB-DLBCL stems from centrocytes in the GC, that are biologically attributed for the favorable prognosis of PB-DLBCL.

符合原发骨淋巴瘤。根据上面这项国际研究，原发骨淋巴瘤基因表达类似于生发中心内的中心细胞，预后良好，5年无进展生存率和总生存率分别是80%和93%。

青青子衿123

橙色雨丝 发表于 2020-9-5 15:27
具体建议不好说，因为不知道放疗的范围与剂量，也不知道白细胞里面的中性粒是多少，如果中性粒在1以上，问 ...

雨丝大神，关于我这种骨淋巴瘤，治疗方法和普通弥漫大b有区别吗？华西医院这边有医生推荐吗

橙色雨丝

青青子衿123 发表于 2020-9-6 08:13
雨丝大神，关于我这种骨淋巴瘤，治疗方法和普通弥漫大b有区别吗？华西医院这边有医生推荐吗
...

没有区别，都是R-CHOP，哪里做都一样。

青青子衿123

青青子衿123 发表于 2020-9-6 08:13
雨丝大神，关于我这种骨淋巴瘤，治疗方法和普通弥漫大b有区别吗？华西医院这边有医生推荐吗
...

好的，谢谢麻烦你了，

三公子

青青子衿123 发表于 2020-9-5 14:30
四疗派特提示cr，评分一分，然后又两个疗程单美罗华，现在放疗中，白细胞低
...

我的情况差不多，就是不能确诊

青青子衿123

三公子 发表于 2020-9-6 13:24
我的情况差不多，就是不能确诊

不是这个病最好啊，不要往上面套症状，

青青子衿123

橙色雨丝 发表于 2020-9-5 15:24
生发中心型弥漫大B，病理上应该没有什么问题。个人认为四疗CR，应该接着再做两个周期的R-CHOP巩固。放疗虽 ...

雨丝大神，我在华西病理会诊结果出来了，好像有一个地方和本市医院不一样，本市提示来源为生发中心，华西提示非生发中心，这个是什么原因啊？有什么影响吗

橙色雨丝

青青子衿123 发表于 2020-9-29 16:40
雨丝大神，我在华西病理会诊结果出来了，好像有一个地方和本市医院不一样，本市提示来源为生发中心，华西 ...

不重要，都快治完了。

青青子衿123

橙色雨丝 发表于 2020-9-29 17:23
不重要，都快治完了。

治疗方案都一样吗

橙色雨丝

青青子衿123 发表于 2020-9-29 20:27
治疗方案都一样吗

一样