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Clinical and pathological evaluation of histopathological subtypes in patients with non-Hodgkin’s lymphoma

Year 2016, Volume: 2 Issue: 1, 52 - 61, 04.03.2016
https://doi.org/10.18621/eurj.2016.2.1.52

Abstract

Objectives. Non-Hodgkin Lymphomas (NHLs) are tumours of the lymphoid system which originate from lymph nodes or extranodal lymphatic tissue. Since they represent a heterogeneous group of diseases, it is very important to determine prognostic factors apart from staging and identification of the patients with poor prognosis. The objective of our study is to investigate clinical characteristics, treatments applied, and their outcomes, survival rates, and prognostic factors which may be effective on survival. Methods. Clinical characteristics, treatments applied, and their outcomes, survivals, and prognostic factors which may be effective on the survival in 230 patients who were diagnosed as NHL, and consulted to our center between the years 2002, and 2015 were retrospectively evaluated. Results. Median age of our patients (male, 54.8 %, and female, 45.2 %) was 57 years. The most frequently seen histopathological subtype was diffuse large β cell lymphoma. We have seen that IPI score, β symptom, levels of LDH, albumin, β2 microglobulin, and lymphocyte counts are significant prognostic factors. Stomach was the most frequently involved extranodal organ. Advanced stage, higher IPI score, extranodal organ involvement were found to be correlated with shorter survival times. Conclusion. Everyday developments occur in the diagnosis, classification, and treatment of NHL. Therefore, it is important for medical centres to evaluate their treatment outcomes, and prognostic factors affecting their survival rates.

References

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  • Swerdlow AJ. Epidemiology of Hodgkin’s disease and non-Hodgkin’s lymphoma. Eur J Nucl Med Mol Imaging. 2003 Jun;30 Suppl 1:S3-12.
  • Ruacan S. THD, WHO classification overview epidemiology and Turkey. Clinician pathologists common lymphoma course 2004;March:14-7.
  • Kuzu I. Recent developments in non-Hodgkin's lymphoma classification. Hematoloji-Onkoloji. 2000;2:256-67.
  • Disel U. Epidemiology of the lymphoma and staging. Turkiye Klinikleri J Med Oncol-Special Topics. 2009;2(2):17-24.
  • American Cancer Society. Cancer facts and figures. 2016. Available from: URL: www.cancer.org. 7 February 2016.
  • Lee SS, Cho KJ, Kim CW, Kang YK. Clinicopathological analysis of 501 non-Hodgkin’s lymphomas in Korea according to the Revised European–American Classification of lymphoid neoplasms. Histopathology. 1999 Oct;35(4):345-54.
  • Cartwright R, Brincker H, Carli PM, Clayden D, Coebergh JW, Jack A, et al. The rise in incidence of lymphomas in Europe 1985-1992. Eu J Cancer. 1999 Apr;35(4):627-33.
  • Mitterlechner T, Fiegl M, Muhlbock H, Oberaigner W, Dirnhofer S, Tzankov A. Epidemiology of non-Hodgkin lymphomas in Tyrol/Austria from 1991 to 2000. J Clin Pathol. 2006 Jan;59(1):48-55.
  • Economopoulos T, Papageorgiou S, Dimopoulos MA, Pavlidis N, Tsatalas C, Symeonidis A, et al. Non-Hodgkin’s lymphomas in Greece according to the WHO classification of lymphoid neoplasms. Acta Haematol. 2005;113(2):97-103.
  • Newton R, Ferlay J, Beral V, Devesa SS. The epidemiology of non-Hodgkin’s lymphoma: comparison of nodal and extra-nodal sites. Int J Cancer. 1997 Sep 17;72(6):923-30.
  • Alici S, Bavbek SE, Kaytan E, Basaran M, Eralp Y, Onat H. Aggressive non-Hodgkin’s lymphoma treated at the Institute of Oncology, Istanbul: Treatment, outcome, and prognostic factors. Am J Clin Oncol. 2002 Oct;25(5):502-8.
  • Ramesh B, Digumarti R, Nair R, Bhurani D, Raina V, Aggarwal S, et al. Histopathological pattern of lymphomas and clinical presentation and outcomes of diffuse large B cell lymphoma: A multicenter registry based study from India Indian J Med Paediatr Oncol. 2013 Oct-Dec;34(4): 299-304.
  • Frederiksen BL, Brown Pde N, Dalton SO, Steding-Jessen M, Osler M. Socioeconomic inequalities in prognostic markers of non-Hodgkin lymphoma: analysis of a national clinical database Eu J Cancer. 2011 Apr;47(6):910-7.
  • Groves FD, Linet MS, Travis LB, Devesa SS. Cancer surveillance series: non-Hodgkin's lymphoma incidence by histologic subtype in the United States from 1978 through 1995. J Natl Cancer Inst. 2000 Aug 2;92(15):1240-51.
  • Devesa SS, Fears T. Non-Hodgkin's lymphoma time trends: United States and international data. Cancer Res. 1992 Oct 1;52(19 Suppl):5432s-5440s.
  • Anderson JR, Armitage JO, Weisenburger DD. Epidemiology of the non-Hodgkin's lymphomas: distributions of the major subtypes differ by geographic locations. Non-Hodgkin's Lymphoma Classification Project. Ann Oncol. 1998 Jul;9(7):717-20.
  • Krol AD, le Cessie S, Snijder S, Kluin-Nelemans JC, Kluin PM, Noordijk EM. Non-Hodgkin’s lymphoma in the Netherlands: Results from a population based registry. Leuk Lymphoma. 2003 Mar;44(3):451-8.
  • Sarpel SC, Paydas S, Tuncer I, Varinli S, Koksal M, Akoglu T. Non-Hodgkin's Iymphomas in Turkey. Cancer. 1988 Oct 15;62(8):1653-7.
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  • Ansell SM. Non-Hodgkin Lymphoma: Diagnosis and Treatment. Mayo Clin Proc. 2015 Aug;90(8):1152-63.
  • Legouffe E, Rodriguez C, Picot MC, Richard B, Klein B, Rossi JF, et al. CRP serum level is a valuable and simple prognostic marker in non-Hodgkin’s lymphoma. Leukemia and Lymphoma 1998 Oct;31(3-4):351-357.
  • Arican A. Primary extranodal lymphomas. Hematoloji-Onkoloji. 2000;2:273-284.
  • Arican A, Dincol D, Akbulut H, Handan O, Demirkazik A, Cay F, et al. Clinicopathologic features and prognostic factors of primary extranodal non-Hodgkin’s lymphoma in Turkey. Am J Clin Oncol. 1999;22(6):587-92.
  • D'Amore F, Christensen BE, Brincker H, Pedersen NT, Thorling K, Hastrup, J et al. Clinicopathological features and prognostic factors in extranodal non-Hodgkin Iymphomas. Eur J Cancer. 1991;27(10):1201-8.
  • Economopoulos T, Asprou N, Stathakis N, Papageorgiou E, Dervenoulas J, Xanthaki K, et al. Primary extranodal NHL in adults: clinicopathological and survival Characteristics. Leuk Lymphoma. 1996 Mar;21(1-2):131-6.
  • Fisher SG, Fisher RI. The epidemiology of non-Hodgkin’s lymphoma. Oncogene. 2004 Aug 23;23(38):6524-34.
  • Altekruse SF, Kosary CL, Krapcho M, Neyman N, Aminou R, Waldron W, et al. SEER Cancer Statistics Review, 1975-2007. National Cancer Institute. 2009:85-111.
  • Mishra P, Das S, Kar R, Jacob SE, Basu D. Primary extranodal non-Hodgkin lymphoma: A 3-year record-based descriptive study from a tertiary care center in Southern India. Indian J Pathol Microbiol. 2015 Jul-Sep;58(3):296-300.
  • A predictive model for aggressive non-Hodgkin's lymphoma. The International Non-Hodgkin's Lymphoma Prognostic Factors Project. N Engl J Med 1993 Sep 30;329(14):987-94.
  • Verdecchia A, Francisci S, Brenner H, Gatta G, Micheli A, Mangone L, et al. Recent cancer survival in Europe: a 2000–02 period analysis of EUROCARE-4 data. Lancet Oncol. 2007 Sep;8(9):784-96.
  • Storm HH, Klint A, Tryggvadóttır L, Gıslum M, Engholm G, Bray F, et al. Trends in the survival of patients diagnosed with malignant neoplasms of lymphoid, haematopoietic, and related tissue in the Nordic countries 1964–2003 followed up to the end of 2006. Acta Oncol. 2010 Jun;49(5):694-712.
  • Shipp MA. Prognostic factors in aggressive non-Hodgkin’s lymphoma: who has “high-risk” disease. Blood. 1994 Mar 1;83(5):1165-73.
  • Osterman B, Jonsson H, Tavelin B, Lenner P. Non-Hodgkin’s lymphoma in northern Sweden. Prognostic factors and response to treatment. Acta Oncol. 1993;32(5):507-15.
  • Kilciksiz S, Payzin B, Caglar BU, Gokce T, Yersal O, Deniz S. Evaluation of standart prognostic factors according to age cut-off values (60 years and 50 years) and peak age in our non-Hodgkin’s lymphomas patients. Turk J Oncol. 2006;21(1):11-9.
  • Lee MY, Tan TD, Feng AC, Liu MC. Clinicopathological analysis of 598 malignant lymphomas in Taiwan: seven-year experience in a single institution. Am J Hematol. 2006 Aug;81(8):568-75.
  • Maksymiuk AW, Bratvold JS, Ezzat W, Tan LK, Skinnider LF. Non-Hodgkin’s lymphoma in Saskatchewan. Cancer. 1994 Feb 1;73(3):711-9.
  • Castella A, Joshi S, Raaschou T, Mason N. Pattern of malignant lymphoma in the United Arab Emirates: a histopathologic and immunologic study in 208 native patients. Acta Oncol. 2001;40(5):660-4.
  • Coiffier B, Gisselbrecht C, Vose JM, Tilly H, Herbrecht R, Bosly A, et al. Prognostic factors in aggressive malignant lymphomas: description and validation of a prognostic index that could identify patients requiring a more intensive therapy. The Groupe d'Etudes des Lymphomes Agressifs. J Clin Oncol. 1991 Feb;9(2):211-9.
  • Solal-Celigny P, Roy P, Colombat P, White J, Armitage JO, Arranz-Saez R, et al. Follicular lymphoma international prognostic index. Blood. 2004 Sep 1;104(5):1258-65.
  • Yoo C, Yoon DH, Suh D. Serum beta-2 microglobulin in malignant lymphomas: an old but powerful prognostic factor. Blood Res. 2014 Sep;49(3):148-53.
Year 2016, Volume: 2 Issue: 1, 52 - 61, 04.03.2016
https://doi.org/10.18621/eurj.2016.2.1.52

Abstract

References

  • Jamil MO, Mehta A. Diffuse large B-cell lymphoma: prognostic markers and their impact on therapy. Expert Rev Hematol. 2016 Feb;19:1-7.
  • Isikdogan A, Ayyildiz O, Buyukcelik A, Arslan A, Tiftik N, Buyukbayram H, et al. Non-Hodgkin's lymphoma in southeast Turkey: clinicopathologic features of 490 cases. Ann Hematol. 2004 May;83(5):265-9.
  • Swerdlow AJ. Epidemiology of Hodgkin’s disease and non-Hodgkin’s lymphoma. Eur J Nucl Med Mol Imaging. 2003 Jun;30 Suppl 1:S3-12.
  • Ruacan S. THD, WHO classification overview epidemiology and Turkey. Clinician pathologists common lymphoma course 2004;March:14-7.
  • Kuzu I. Recent developments in non-Hodgkin's lymphoma classification. Hematoloji-Onkoloji. 2000;2:256-67.
  • Disel U. Epidemiology of the lymphoma and staging. Turkiye Klinikleri J Med Oncol-Special Topics. 2009;2(2):17-24.
  • American Cancer Society. Cancer facts and figures. 2016. Available from: URL: www.cancer.org. 7 February 2016.
  • Lee SS, Cho KJ, Kim CW, Kang YK. Clinicopathological analysis of 501 non-Hodgkin’s lymphomas in Korea according to the Revised European–American Classification of lymphoid neoplasms. Histopathology. 1999 Oct;35(4):345-54.
  • Cartwright R, Brincker H, Carli PM, Clayden D, Coebergh JW, Jack A, et al. The rise in incidence of lymphomas in Europe 1985-1992. Eu J Cancer. 1999 Apr;35(4):627-33.
  • Mitterlechner T, Fiegl M, Muhlbock H, Oberaigner W, Dirnhofer S, Tzankov A. Epidemiology of non-Hodgkin lymphomas in Tyrol/Austria from 1991 to 2000. J Clin Pathol. 2006 Jan;59(1):48-55.
  • Economopoulos T, Papageorgiou S, Dimopoulos MA, Pavlidis N, Tsatalas C, Symeonidis A, et al. Non-Hodgkin’s lymphomas in Greece according to the WHO classification of lymphoid neoplasms. Acta Haematol. 2005;113(2):97-103.
  • Newton R, Ferlay J, Beral V, Devesa SS. The epidemiology of non-Hodgkin’s lymphoma: comparison of nodal and extra-nodal sites. Int J Cancer. 1997 Sep 17;72(6):923-30.
  • Alici S, Bavbek SE, Kaytan E, Basaran M, Eralp Y, Onat H. Aggressive non-Hodgkin’s lymphoma treated at the Institute of Oncology, Istanbul: Treatment, outcome, and prognostic factors. Am J Clin Oncol. 2002 Oct;25(5):502-8.
  • Ramesh B, Digumarti R, Nair R, Bhurani D, Raina V, Aggarwal S, et al. Histopathological pattern of lymphomas and clinical presentation and outcomes of diffuse large B cell lymphoma: A multicenter registry based study from India Indian J Med Paediatr Oncol. 2013 Oct-Dec;34(4): 299-304.
  • Frederiksen BL, Brown Pde N, Dalton SO, Steding-Jessen M, Osler M. Socioeconomic inequalities in prognostic markers of non-Hodgkin lymphoma: analysis of a national clinical database Eu J Cancer. 2011 Apr;47(6):910-7.
  • Groves FD, Linet MS, Travis LB, Devesa SS. Cancer surveillance series: non-Hodgkin's lymphoma incidence by histologic subtype in the United States from 1978 through 1995. J Natl Cancer Inst. 2000 Aug 2;92(15):1240-51.
  • Devesa SS, Fears T. Non-Hodgkin's lymphoma time trends: United States and international data. Cancer Res. 1992 Oct 1;52(19 Suppl):5432s-5440s.
  • Anderson JR, Armitage JO, Weisenburger DD. Epidemiology of the non-Hodgkin's lymphomas: distributions of the major subtypes differ by geographic locations. Non-Hodgkin's Lymphoma Classification Project. Ann Oncol. 1998 Jul;9(7):717-20.
  • Krol AD, le Cessie S, Snijder S, Kluin-Nelemans JC, Kluin PM, Noordijk EM. Non-Hodgkin’s lymphoma in the Netherlands: Results from a population based registry. Leuk Lymphoma. 2003 Mar;44(3):451-8.
  • Sarpel SC, Paydas S, Tuncer I, Varinli S, Koksal M, Akoglu T. Non-Hodgkin's Iymphomas in Turkey. Cancer. 1988 Oct 15;62(8):1653-7.
  • Barista I, Tekuzman G, Firat D, Baltali E, Kansu E, Kars A, et al. Non-Hodgkin’ lymphoma in Turkey: eighteen years’ expirience at the Hacettepe University. Jpn Cancer Res. 1994 Dec;85(12):1200-7.
  • Ansell SM. Non-Hodgkin Lymphoma: Diagnosis and Treatment. Mayo Clin Proc. 2015 Aug;90(8):1152-63.
  • Legouffe E, Rodriguez C, Picot MC, Richard B, Klein B, Rossi JF, et al. CRP serum level is a valuable and simple prognostic marker in non-Hodgkin’s lymphoma. Leukemia and Lymphoma 1998 Oct;31(3-4):351-357.
  • Arican A. Primary extranodal lymphomas. Hematoloji-Onkoloji. 2000;2:273-284.
  • Arican A, Dincol D, Akbulut H, Handan O, Demirkazik A, Cay F, et al. Clinicopathologic features and prognostic factors of primary extranodal non-Hodgkin’s lymphoma in Turkey. Am J Clin Oncol. 1999;22(6):587-92.
  • D'Amore F, Christensen BE, Brincker H, Pedersen NT, Thorling K, Hastrup, J et al. Clinicopathological features and prognostic factors in extranodal non-Hodgkin Iymphomas. Eur J Cancer. 1991;27(10):1201-8.
  • Economopoulos T, Asprou N, Stathakis N, Papageorgiou E, Dervenoulas J, Xanthaki K, et al. Primary extranodal NHL in adults: clinicopathological and survival Characteristics. Leuk Lymphoma. 1996 Mar;21(1-2):131-6.
  • Fisher SG, Fisher RI. The epidemiology of non-Hodgkin’s lymphoma. Oncogene. 2004 Aug 23;23(38):6524-34.
  • Altekruse SF, Kosary CL, Krapcho M, Neyman N, Aminou R, Waldron W, et al. SEER Cancer Statistics Review, 1975-2007. National Cancer Institute. 2009:85-111.
  • Mishra P, Das S, Kar R, Jacob SE, Basu D. Primary extranodal non-Hodgkin lymphoma: A 3-year record-based descriptive study from a tertiary care center in Southern India. Indian J Pathol Microbiol. 2015 Jul-Sep;58(3):296-300.
  • A predictive model for aggressive non-Hodgkin's lymphoma. The International Non-Hodgkin's Lymphoma Prognostic Factors Project. N Engl J Med 1993 Sep 30;329(14):987-94.
  • Verdecchia A, Francisci S, Brenner H, Gatta G, Micheli A, Mangone L, et al. Recent cancer survival in Europe: a 2000–02 period analysis of EUROCARE-4 data. Lancet Oncol. 2007 Sep;8(9):784-96.
  • Storm HH, Klint A, Tryggvadóttır L, Gıslum M, Engholm G, Bray F, et al. Trends in the survival of patients diagnosed with malignant neoplasms of lymphoid, haematopoietic, and related tissue in the Nordic countries 1964–2003 followed up to the end of 2006. Acta Oncol. 2010 Jun;49(5):694-712.
  • Shipp MA. Prognostic factors in aggressive non-Hodgkin’s lymphoma: who has “high-risk” disease. Blood. 1994 Mar 1;83(5):1165-73.
  • Osterman B, Jonsson H, Tavelin B, Lenner P. Non-Hodgkin’s lymphoma in northern Sweden. Prognostic factors and response to treatment. Acta Oncol. 1993;32(5):507-15.
  • Kilciksiz S, Payzin B, Caglar BU, Gokce T, Yersal O, Deniz S. Evaluation of standart prognostic factors according to age cut-off values (60 years and 50 years) and peak age in our non-Hodgkin’s lymphomas patients. Turk J Oncol. 2006;21(1):11-9.
  • Lee MY, Tan TD, Feng AC, Liu MC. Clinicopathological analysis of 598 malignant lymphomas in Taiwan: seven-year experience in a single institution. Am J Hematol. 2006 Aug;81(8):568-75.
  • Maksymiuk AW, Bratvold JS, Ezzat W, Tan LK, Skinnider LF. Non-Hodgkin’s lymphoma in Saskatchewan. Cancer. 1994 Feb 1;73(3):711-9.
  • Castella A, Joshi S, Raaschou T, Mason N. Pattern of malignant lymphoma in the United Arab Emirates: a histopathologic and immunologic study in 208 native patients. Acta Oncol. 2001;40(5):660-4.
  • Coiffier B, Gisselbrecht C, Vose JM, Tilly H, Herbrecht R, Bosly A, et al. Prognostic factors in aggressive malignant lymphomas: description and validation of a prognostic index that could identify patients requiring a more intensive therapy. The Groupe d'Etudes des Lymphomes Agressifs. J Clin Oncol. 1991 Feb;9(2):211-9.
  • Solal-Celigny P, Roy P, Colombat P, White J, Armitage JO, Arranz-Saez R, et al. Follicular lymphoma international prognostic index. Blood. 2004 Sep 1;104(5):1258-65.
  • Yoo C, Yoon DH, Suh D. Serum beta-2 microglobulin in malignant lymphomas: an old but powerful prognostic factor. Blood Res. 2014 Sep;49(3):148-53.
There are 42 citations in total.

Details

Journal Section Original Articles
Authors

Feray Tabakan This is me

Erdinc Nayir

Ali Arican

Publication Date March 4, 2016
Submission Date February 8, 2016
Published in Issue Year 2016 Volume: 2 Issue: 1

Cite

AMA Tabakan F, Nayir E, Arican A. Clinical and pathological evaluation of histopathological subtypes in patients with non-Hodgkin’s lymphoma. Eur Res J. March 2016;2(1):52-61. doi:10.18621/eurj.2016.2.1.52

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