medicina58巻13号

2021年12月発行

特集 血液疾患をプライマリ・ケアではどこまで診て，どのように専門医と連携をとるべきか？ 専門医の診断・治療後に一般内科医，プライマリ・ケア医との連携を行う場合

低悪性度リンパ腫（indolent lymphoma）の経過観察・再紹介について

著者： 賴晋也¹

所属機関： ¹近畿大学病院血液・膠原病内科

ページ範囲：P.2190 - P.2193

Point
◎低悪性度リンパ腫（indolent lymphoma）の代表疾患である濾胞性リンパ腫（FL）の罹患数は増加傾向にある．
◎FLは緩徐な臨床経過を示すことが多く，腫瘍量を目安に治療介入の時期が検討される．
◎初回治療奏効例においても長期的にみると再発をきたすことが多く，特に診断から2年以内に早期再発/増悪した（early POD）群の予後は不良である．
◎一方，非early POD群では多くの例で長期生存が期待できることより，二次がんをはじめとした晩期合併症を見逃さないことも重要である．
◎経過観察中に突然の急速なリンパ節腫大やLDHの上昇，高カルシウム血症，B症状などが認められた場合はアグレッシブリンパ腫（aggressive lymphoma）への形質転換を疑い，専門医へ再紹介する必要がある．

参考文献

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