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Factors associated with unresponsiveness to treatment in patients with non-Hodgkin lymphoma: 10 years of experience from a single center

Year 2023, Volume: 7 Issue: 1, 66 - 80, 21.06.2023
https://doi.org/10.30565/medalanya.1269949

Abstract

Aim: To investigate factors associated with response to treatment in non-Hodgkin lymphoma (NHL) patients receiving chemo(radio)therapy, and secondarily, to identify parameters influencing mortality.

Methods: This was a retrospective single center study carried out between January 2013 and December 2022. A total of 245 patients newly diagnosed with NHL who were treated in our department were included. Clinicodemographic features, NHL characteristics, treatments and follow-up data were retrieved from the hospital database and charts. Patients were grouped as responders (RT) and non-responders (NRT) to treatment, as well as deceased (DP) and survivors (SP). Factors associated with response to treatment and mortality were determined by univariate and multivariable analysis.

Results: Age was similar in the RT (56.2 ± 14.5) and NRT (59.5 ± 13.7) groups; however, male sex was significantly more frequent in the RT group (58.1% vs. 35.71%; p = 0.042). Multiple logistic regression revealed that female sex, low performance status, frailty, high lymphocyte level, extranodal involvement, mantle cell lymphoma, thrombocytopenia during treatment, and cardiac complications during treatment were independently associated with no response to treatment. With respect to groups based on mortality, the DP group was significantly younger compared to the SP group (50.8 ± 11.7 vs. 57.1 ± 14.6; p = 0.048), while sex distribution was similar (males comprised 54.7% of the DP and 63.6% of SP group). Multiple regression showed that extranodal involvement, thrombosis during treatment, and secondary malignancy were independently associated with mortality.

Conclusion: Considering these characteristics when making treatment decisions and throughout the follow-up period may improve survival and reduce mortality in NHL.

References

  • 1. Armitage JO, Gascoyne RD, Lunning MA, Cavalli F. Non-Hodgkin lymphoma. Lancet. 2017;390(10091):298-310. doi: 10.1016/s0140-6736(16)32407-2.
  • 2. Luo J, Craver A, Bahl K, Stepniak L, Moore K, King J, et al. Etiology of non-Hodgkin lymphoma: A review from epidemiologic studies. J Natl Cancer Cent. 2022;2(4):226-34. doi: 10.1016/j.jncc.2022.08.003
  • 3. Sapkota S, Shaikh H. Non-Hodgkin Lymphoma. StatPearls. Treasure Island (FL): StatPearls Publishing Copyright © 2022, StatPearls Publishing LLC.; 2022.
  • 4. International Non-Hodgkin's Lymphoma Prognostic Factors Project. A predictive model for aggressive non-Hodgkin's lymphoma. N Engl J Med. 1993;329(14):987-94. doi: 10.1056/nejm199309303291402.
  • 5. Sehn LH, Berry B, Chhanabhai M, Fitzgerald C, Gill K, Hoskins P, et al. The revised International Prognostic Index (R-IPI) is a better predictor of outcome than the standard IPI for patients with diffuse large B-cell lymphoma treated with R-CHOP. Blood. 2007;109(5):1857-61. doi: 10.1182/blood-2006-08-038257.
  • 6. Wang J, Zhou M, Xu JY, Chen B, Ouyang J. Combination of BCL-2 and MYC protein expression improves high-risk stratification in diffuse large B-cell lymphoma. Onco Targets Ther. 2015;8:2645-50. doi: 10.2147/ott.S86093.
  • 7. Zhou Z, Sehn LH, Rademaker AW, Gordon LI, Lacasce AS, Crosby-Thompson A, et al. An enhanced International Prognostic Index (NCCN-IPI) for patients with diffuse large B-cell lymphoma treated in the rituximab era. Blood. 2014;123(6):837-42. doi: 10.1182/blood-2013-09-524108.
  • 8. Hoster E, Dreyling M, Klapper W, Gisselbrecht C, Van Hoof A, Kluin-Nelemans HC, et al. A new prognostic index (MIPI) for patients with advanced-stage mantle cell lymphoma. Blood. 2008;111(2):558-65. doi: 10.1182/blood-2007-06-095331.
  • 9. Gallamini A, Stelitano C, Calvi R, Bellei M, Mattei D, Vitolo U, et al. Peripheral T-cell lymphoma unspecified (PTCL-U): a new prognostic model from a retrospective multicentric clinical study. Blood. 2004;103(7):2474-9. doi: 10.1182/blood-2003-09-3080.
  • 10. He H, Tan F, Xue Q, Liu L, Peng Y, Bai G, et al. Clinicopathological characteristics and prognostic factors of primary pulmonary lymphoma. J Thorac Dis. 2021;13(2):1106-17. doi: 10.21037/jtd-20-3159.
  • 11. Kupik O, Akin S, Tuncel M, Eren G, Türker A, Kars A, et al. Comparison of clinical and PET-derived prognostic factors in patients with non-Hodgkin lymphoma: a special emphasis on bone marrow involvement. Nucl Med Commun. 2020;41(6):540-9. doi: 10.1097/mnm.0000000000001182.
  • 12. Wang YG, Zhao LY, Liu CQ, Pan SC, Chen XL, Liu K, et al. Clinical characteristics and prognostic factors of primary gastric lymphoma: A retrospective study with 165 cases. Medicine (Baltimore). 2016;95(31):e4250. doi: 10.1097/md.0000000000004250.
  • 13. Lucijanic M, Huzjan Korunic R, Sedinic M, Kusec R, Pejsa V. More Pronounced Muscle Loss During Immunochemotherapy is Associated with Worse Clinical Outcomes in Newly Diagnosed Patients with Diffuse Large B-Cell Lymphoma with Unfavorable Features. Ther Clin Risk Manag. 2021;17:1037-44. doi: 10.2147/tcrm.S323749.
  • 14. Huang T, Wang T, Fang X, Su P, Huang X, Fu H, et al. Evaluation of the clinical characteristics and prognostic factors of gastrointestinal non-Hodgkin lymphoma based on anatomical sites and histological subtype. Scand J Gastroenterol. 2023:1-6. doi: 10.1080/00365521.2023.2173987.
  • 15. Provencio M, Rodríguez M, Cantos B, Sabín P, Quero C, García-Arroyo FR, et al. mRNA in exosomas as a liquid biopsy in non-Hodgkin Lymphoma: a multicentric study by the Spanish Lymphoma Oncology Group. Oncotarget. 2017;8(31):50949-57. doi: 10.18632/oncotarget.16435.
  • 16. Moormeier JA, Williams SF, Golomb HM. The staging of non-Hodgkin's lymphomas. Semin Oncol. 1990;17(1):43-50. PMID: 2406917
  • 17. Conill C, Verger E, Salamero M. Performance status assessment in cancer patients. Cancer. 1990;65(8):1864-6. doi: 10.1002/1097-0142(19900415)65:8<1864::aid-cncr2820650832>3.0.co;2-u.
  • 18. Lewis WD, Lilly S, Jones KL. Lymphoma: diagnosis and treatment. Am Fam Physician. 2020;101(1):34-41. PMID: 31894937
  • 19. Morley JE, Malmstrom TK, Miller DK. A simple frailty questionnaire (FRAIL) predicts outcomes in middle aged African Americans. J Nutr Health Aging. 2012;16(7):601-8. doi: 10.1007/s12603-012-0084-2.
  • 20. Di Cello A, Borelli M, Marra ML, Franzon M, D'alessandro P, Di Carlo C, et al. A more accurate method to interpret lactate dehydrogenase (LDH) isoenzymes' results in patients with uterine masses. Eur J Obstet Gynecol Reprod Biol. 2019;236:143-7. doi: 10.1016/j.ejogrb.2019.03.017.
  • 21. Cheson BD, Pfistner B, Juweid ME, Gascoyne RD, Specht L, Horning SJ, et al. Revised response criteria for malignant lymphoma. J Clin Oncol. 2007;25(5):579-86. doi: 10.1200/jco.2006.09.2403.
  • 22. Cappellini MD, Motta I. Anemia in Clinical Practice-Definition and Classification: Does Hemoglobin Change With Aging? Semin Hematol. 2015;52(4):261-9. doi: 10.1053/j.seminhematol.2015.07.006.
  • 23. Peddaverannagari T, Chakkirala N, Prabhala S, Deshpande A. Utility of Platelet Count and Platelet Indices in the Evaluation of Thrombocytopenia. J Evid Based Med Healthc. 2020;7(49):2974-80. DOI: 10.18410/jebmh/2020/608
  • 24. Schiffer CA, Anderson KC, Bennett CL, Bernstein S, Elting LS, Goldsmith M, et al. Platelet transfusion for patients with cancer: clinical practice guidelines of the American Society of Clinical Oncology. J Clin Oncol. 2001;19(5):1519-38. doi: 10.1200/jco.2001.19.5.1519.
  • 25. Schiffer CA, Bohlke K, Delaney M, Hume H, Magdalinski AJ, Mccullough JJ, et al. Platelet transfusion for patients with cancer: American society of clinical oncology clinical practice guideline update. J Clin Oncol. 2018;36(3):283-99. doi: 10.1200/jco.2017.76.1734.
  • 26. Matera RM, Relias V, Saif MW. Safety and efficacy of same-day administration of pegfilgrastim in patients receiving chemotherapy for gastrointestinal malignancies. Cancer Med J. 2021;4(1):6-11. PMID: 32656544
  • 27. Zheng B, Toarta C, Cheng W, Taljaard M, Reaume N, Perry JJ. Accuracy of the Multinational Association of Supportive Care in Cancer (MASCC) and Clinical Index of Stable Febrile Neutropenia (CISNE) scores for predicting serious complications in adult patients with febrile neutropenia: A systematic review and meta-analysis. Crit Rev Oncol Hematol. 2020;149:102922. doi: 10.1016/j.critrevonc.2020.102922.
  • 28. Taplitz RA, Kennedy EB, Bow EJ, Crews J, Gleason C, Hawley DK, et al. Outpatient management of fever and neutropenia in adults treated for malignancy: American society of clinical oncology and ınfectious diseases society of America clinical practice guideline update. J Clin Oncol. 2018;36(14):1443-53. doi: 10.1200/jco.2017.77.6211.
  • 29. Freifeld AG, Bow EJ, Sepkowitz KA, Boeckh MJ, Ito JI, Mullen CA, et al. Clinical practice guideline for the use of antimicrobial agents in neutropenic patients with cancer: 2010 update by the infectious diseases society of america. Clin Infect Dis. 2011;52(4):e56-93. doi: 10.1093/cid/cir073.
  • 30. Schirmbeck NG, Mey UJ, Olivieri A, Ko YD, Kaiser U, Flieger D, et al. Salvage chemotherapy with R-DHAP in patients with relapsed or refractory non-hodgkin lymphoma. Cancer Invest. 2016;34(8):361-72. doi: 10.1080/07357907.2016.1212062.
  • 31. Bairey O, Shacham-Abulafia A, Shpilberg O, Gurion R. Serum albumin level at diagnosis of diffuse large B-cell lymphoma: an important simple prognostic factor. Hematol Oncol. 2016;34(4):184-92. doi: 10.1002/hon.2233.
  • 32. Olszewski AJ, Ollila T, Reagan JL. Time to treatment is an independent prognostic factor in aggressive non-Hodgkin lymphomas. Br J Haematol. 2018;181(4):495-504. doi: 10.1111/bjh.15224.
  • 33. Wang J, Zhou M, Wang X, Xu J, Chen B, Ouyang J. Pretreatment C-reactive protein was an independent prognostic factor for patients with diffuse large B-cell lymphoma treated with RCHOP. Clin Chim Acta. 2016;459:150-4. doi: 10.1016/j.cca.2016.05.033.
  • 34. Shannon EM, Macqueen IT, Miller JM, Maggard-Gibbons M. Management of primary gastrointestinal non-hodgkin lymphomas: A population-based survival analysis. J Gastrointest Surg. 2016;20(6):1141-9. doi: 10.1007/s11605-016-3129-8.
  • 35. Pillon M, Xavier AC, Cairo MS. Prognostic Factors in Childhood and Adolescent Non-Hodgkin Lymphoma. In: Oussama Abla AA, editor. Non-Hodgkin's Lymphoma in Childhood Adolescence Springer; 2019. p. 131-49.
  • 36. Jiang Y, Miao Z, Wang J, Chen J, Lv Y, Xing D, et al. Clinical characteristics and prognosis associated with multiple primary malignant tumors in non-Hodgkin lymphoma patients. Tumori. 2019;105(6):474-82. doi: 10.1177/0300891619839475.
  • 37. Gaudio F, Pedote P, Asabella AN, Perrone T, Laddaga FE, Sindaco P, et al. Extralymphatic disease ıs an ındependent prognostic factor in hodgkin lymphoma. Clin Lymphoma Myeloma Leuk. 2018;18(6):e261-e6. doi: 10.1016/j.clml.2018.04.001.

Non-Hodgkin lenfoma hastalarında tedaviye yanıtsızlık ile ilişkili faktörler: Tek merkezden 10 yıllık deneyim

Year 2023, Volume: 7 Issue: 1, 66 - 80, 21.06.2023
https://doi.org/10.30565/medalanya.1269949

Abstract

Amaç: Kemo(radyo)terapi alan non-Hodgkin lenfoma (NHL) hastalarında tedaviye yanıtla ilişkili faktörleri araştırmak ve ikincil olarak mortaliteyi etkileyen parametreleri belirlemek.

Yöntemler: Bu çalışma Ocak 2013-Aralık 2022 tarihleri arasında retrospektif tek merkezli olarak gerçekleştirilmiştir. Bölümümüzde tedavi gören yeni NHL tanısı almış toplam 245 hasta çalışmaya dahil edilmiştir. Klinikodemografik özellikler, NHL özellikleri, tedavi ve takip verileri hastane veri tabanından ve kayıtlarındna elde edilmiştir. Hastalar tedaviye yanıt verenler (RT) ve yanıt vermeyenler (NRT) ile ölenler (DP) ve hayatta kalanlar (SP) olarak gruplandırılmıştır. Tedaviye yanıt ve mortalite ile ilişkili faktörler, tek değişkenli ve çok değişkenli analizlerle belirlenmiştir.

Bulgular: RT (56,2 ± 14,5) ve NRT (59,5 ± 13,7) gruplarında yaş benzerdi; ancak erkek cinsiyet RT grubunda anlamlı olarak daha sıktı (%58.1'e karşı %35.71; p = 0.042). Çoklu lojistik regresyon, kadın cinsiyet, düşük performans durumu, kırılganlık, yüksek lenfosit düzeyi, ekstranodal tutulum, mantle hücreli lenfoma, tedavi sırasında trombositopeni ve tedavi sırasında kardiyak komplikasyonların tedaviye yanıtsızlıkla bağımsız olarak ilişkili olduğunu ortaya koydu. Mortaliteye dayalı gruplara göre, DP grubu SP grubuna kıyasla anlamlı düzeyde daha gençti (50,8 ± 11,7'ye karşı 57,1 ± 14,6; p = 0,048), cinsiyet dağılımı benzerdi (erkekler DP'nin %54,7'sini ve SP’nin %63,6'sını oluşturuyordu). Çoklu regresyon, ekstranodal tutulum, tedavi sırasında tromboz ve sekonder malignitenin mortalite ile bağımsız olarak ilişkili olduğunu gösterdi.

Sonuç: NHL'de tedavi kararı verilirken ve takip süresince bu özelliklerin göz önünde bulundurulması sağkalımı artırabilir ve mortaliteyi azaltabilir.

References

  • 1. Armitage JO, Gascoyne RD, Lunning MA, Cavalli F. Non-Hodgkin lymphoma. Lancet. 2017;390(10091):298-310. doi: 10.1016/s0140-6736(16)32407-2.
  • 2. Luo J, Craver A, Bahl K, Stepniak L, Moore K, King J, et al. Etiology of non-Hodgkin lymphoma: A review from epidemiologic studies. J Natl Cancer Cent. 2022;2(4):226-34. doi: 10.1016/j.jncc.2022.08.003
  • 3. Sapkota S, Shaikh H. Non-Hodgkin Lymphoma. StatPearls. Treasure Island (FL): StatPearls Publishing Copyright © 2022, StatPearls Publishing LLC.; 2022.
  • 4. International Non-Hodgkin's Lymphoma Prognostic Factors Project. A predictive model for aggressive non-Hodgkin's lymphoma. N Engl J Med. 1993;329(14):987-94. doi: 10.1056/nejm199309303291402.
  • 5. Sehn LH, Berry B, Chhanabhai M, Fitzgerald C, Gill K, Hoskins P, et al. The revised International Prognostic Index (R-IPI) is a better predictor of outcome than the standard IPI for patients with diffuse large B-cell lymphoma treated with R-CHOP. Blood. 2007;109(5):1857-61. doi: 10.1182/blood-2006-08-038257.
  • 6. Wang J, Zhou M, Xu JY, Chen B, Ouyang J. Combination of BCL-2 and MYC protein expression improves high-risk stratification in diffuse large B-cell lymphoma. Onco Targets Ther. 2015;8:2645-50. doi: 10.2147/ott.S86093.
  • 7. Zhou Z, Sehn LH, Rademaker AW, Gordon LI, Lacasce AS, Crosby-Thompson A, et al. An enhanced International Prognostic Index (NCCN-IPI) for patients with diffuse large B-cell lymphoma treated in the rituximab era. Blood. 2014;123(6):837-42. doi: 10.1182/blood-2013-09-524108.
  • 8. Hoster E, Dreyling M, Klapper W, Gisselbrecht C, Van Hoof A, Kluin-Nelemans HC, et al. A new prognostic index (MIPI) for patients with advanced-stage mantle cell lymphoma. Blood. 2008;111(2):558-65. doi: 10.1182/blood-2007-06-095331.
  • 9. Gallamini A, Stelitano C, Calvi R, Bellei M, Mattei D, Vitolo U, et al. Peripheral T-cell lymphoma unspecified (PTCL-U): a new prognostic model from a retrospective multicentric clinical study. Blood. 2004;103(7):2474-9. doi: 10.1182/blood-2003-09-3080.
  • 10. He H, Tan F, Xue Q, Liu L, Peng Y, Bai G, et al. Clinicopathological characteristics and prognostic factors of primary pulmonary lymphoma. J Thorac Dis. 2021;13(2):1106-17. doi: 10.21037/jtd-20-3159.
  • 11. Kupik O, Akin S, Tuncel M, Eren G, Türker A, Kars A, et al. Comparison of clinical and PET-derived prognostic factors in patients with non-Hodgkin lymphoma: a special emphasis on bone marrow involvement. Nucl Med Commun. 2020;41(6):540-9. doi: 10.1097/mnm.0000000000001182.
  • 12. Wang YG, Zhao LY, Liu CQ, Pan SC, Chen XL, Liu K, et al. Clinical characteristics and prognostic factors of primary gastric lymphoma: A retrospective study with 165 cases. Medicine (Baltimore). 2016;95(31):e4250. doi: 10.1097/md.0000000000004250.
  • 13. Lucijanic M, Huzjan Korunic R, Sedinic M, Kusec R, Pejsa V. More Pronounced Muscle Loss During Immunochemotherapy is Associated with Worse Clinical Outcomes in Newly Diagnosed Patients with Diffuse Large B-Cell Lymphoma with Unfavorable Features. Ther Clin Risk Manag. 2021;17:1037-44. doi: 10.2147/tcrm.S323749.
  • 14. Huang T, Wang T, Fang X, Su P, Huang X, Fu H, et al. Evaluation of the clinical characteristics and prognostic factors of gastrointestinal non-Hodgkin lymphoma based on anatomical sites and histological subtype. Scand J Gastroenterol. 2023:1-6. doi: 10.1080/00365521.2023.2173987.
  • 15. Provencio M, Rodríguez M, Cantos B, Sabín P, Quero C, García-Arroyo FR, et al. mRNA in exosomas as a liquid biopsy in non-Hodgkin Lymphoma: a multicentric study by the Spanish Lymphoma Oncology Group. Oncotarget. 2017;8(31):50949-57. doi: 10.18632/oncotarget.16435.
  • 16. Moormeier JA, Williams SF, Golomb HM. The staging of non-Hodgkin's lymphomas. Semin Oncol. 1990;17(1):43-50. PMID: 2406917
  • 17. Conill C, Verger E, Salamero M. Performance status assessment in cancer patients. Cancer. 1990;65(8):1864-6. doi: 10.1002/1097-0142(19900415)65:8<1864::aid-cncr2820650832>3.0.co;2-u.
  • 18. Lewis WD, Lilly S, Jones KL. Lymphoma: diagnosis and treatment. Am Fam Physician. 2020;101(1):34-41. PMID: 31894937
  • 19. Morley JE, Malmstrom TK, Miller DK. A simple frailty questionnaire (FRAIL) predicts outcomes in middle aged African Americans. J Nutr Health Aging. 2012;16(7):601-8. doi: 10.1007/s12603-012-0084-2.
  • 20. Di Cello A, Borelli M, Marra ML, Franzon M, D'alessandro P, Di Carlo C, et al. A more accurate method to interpret lactate dehydrogenase (LDH) isoenzymes' results in patients with uterine masses. Eur J Obstet Gynecol Reprod Biol. 2019;236:143-7. doi: 10.1016/j.ejogrb.2019.03.017.
  • 21. Cheson BD, Pfistner B, Juweid ME, Gascoyne RD, Specht L, Horning SJ, et al. Revised response criteria for malignant lymphoma. J Clin Oncol. 2007;25(5):579-86. doi: 10.1200/jco.2006.09.2403.
  • 22. Cappellini MD, Motta I. Anemia in Clinical Practice-Definition and Classification: Does Hemoglobin Change With Aging? Semin Hematol. 2015;52(4):261-9. doi: 10.1053/j.seminhematol.2015.07.006.
  • 23. Peddaverannagari T, Chakkirala N, Prabhala S, Deshpande A. Utility of Platelet Count and Platelet Indices in the Evaluation of Thrombocytopenia. J Evid Based Med Healthc. 2020;7(49):2974-80. DOI: 10.18410/jebmh/2020/608
  • 24. Schiffer CA, Anderson KC, Bennett CL, Bernstein S, Elting LS, Goldsmith M, et al. Platelet transfusion for patients with cancer: clinical practice guidelines of the American Society of Clinical Oncology. J Clin Oncol. 2001;19(5):1519-38. doi: 10.1200/jco.2001.19.5.1519.
  • 25. Schiffer CA, Bohlke K, Delaney M, Hume H, Magdalinski AJ, Mccullough JJ, et al. Platelet transfusion for patients with cancer: American society of clinical oncology clinical practice guideline update. J Clin Oncol. 2018;36(3):283-99. doi: 10.1200/jco.2017.76.1734.
  • 26. Matera RM, Relias V, Saif MW. Safety and efficacy of same-day administration of pegfilgrastim in patients receiving chemotherapy for gastrointestinal malignancies. Cancer Med J. 2021;4(1):6-11. PMID: 32656544
  • 27. Zheng B, Toarta C, Cheng W, Taljaard M, Reaume N, Perry JJ. Accuracy of the Multinational Association of Supportive Care in Cancer (MASCC) and Clinical Index of Stable Febrile Neutropenia (CISNE) scores for predicting serious complications in adult patients with febrile neutropenia: A systematic review and meta-analysis. Crit Rev Oncol Hematol. 2020;149:102922. doi: 10.1016/j.critrevonc.2020.102922.
  • 28. Taplitz RA, Kennedy EB, Bow EJ, Crews J, Gleason C, Hawley DK, et al. Outpatient management of fever and neutropenia in adults treated for malignancy: American society of clinical oncology and ınfectious diseases society of America clinical practice guideline update. J Clin Oncol. 2018;36(14):1443-53. doi: 10.1200/jco.2017.77.6211.
  • 29. Freifeld AG, Bow EJ, Sepkowitz KA, Boeckh MJ, Ito JI, Mullen CA, et al. Clinical practice guideline for the use of antimicrobial agents in neutropenic patients with cancer: 2010 update by the infectious diseases society of america. Clin Infect Dis. 2011;52(4):e56-93. doi: 10.1093/cid/cir073.
  • 30. Schirmbeck NG, Mey UJ, Olivieri A, Ko YD, Kaiser U, Flieger D, et al. Salvage chemotherapy with R-DHAP in patients with relapsed or refractory non-hodgkin lymphoma. Cancer Invest. 2016;34(8):361-72. doi: 10.1080/07357907.2016.1212062.
  • 31. Bairey O, Shacham-Abulafia A, Shpilberg O, Gurion R. Serum albumin level at diagnosis of diffuse large B-cell lymphoma: an important simple prognostic factor. Hematol Oncol. 2016;34(4):184-92. doi: 10.1002/hon.2233.
  • 32. Olszewski AJ, Ollila T, Reagan JL. Time to treatment is an independent prognostic factor in aggressive non-Hodgkin lymphomas. Br J Haematol. 2018;181(4):495-504. doi: 10.1111/bjh.15224.
  • 33. Wang J, Zhou M, Wang X, Xu J, Chen B, Ouyang J. Pretreatment C-reactive protein was an independent prognostic factor for patients with diffuse large B-cell lymphoma treated with RCHOP. Clin Chim Acta. 2016;459:150-4. doi: 10.1016/j.cca.2016.05.033.
  • 34. Shannon EM, Macqueen IT, Miller JM, Maggard-Gibbons M. Management of primary gastrointestinal non-hodgkin lymphomas: A population-based survival analysis. J Gastrointest Surg. 2016;20(6):1141-9. doi: 10.1007/s11605-016-3129-8.
  • 35. Pillon M, Xavier AC, Cairo MS. Prognostic Factors in Childhood and Adolescent Non-Hodgkin Lymphoma. In: Oussama Abla AA, editor. Non-Hodgkin's Lymphoma in Childhood Adolescence Springer; 2019. p. 131-49.
  • 36. Jiang Y, Miao Z, Wang J, Chen J, Lv Y, Xing D, et al. Clinical characteristics and prognosis associated with multiple primary malignant tumors in non-Hodgkin lymphoma patients. Tumori. 2019;105(6):474-82. doi: 10.1177/0300891619839475.
  • 37. Gaudio F, Pedote P, Asabella AN, Perrone T, Laddaga FE, Sindaco P, et al. Extralymphatic disease ıs an ındependent prognostic factor in hodgkin lymphoma. Clin Lymphoma Myeloma Leuk. 2018;18(6):e261-e6. doi: 10.1016/j.clml.2018.04.001.
There are 37 citations in total.

Details

Primary Language English
Subjects ​Internal Diseases
Journal Section Research Article
Authors

Yildiz Ipek 0000-0003-2952-2286

Güven Yılmaz

Early Pub Date May 28, 2023
Publication Date June 21, 2023
Submission Date March 23, 2023
Acceptance Date April 23, 2023
Published in Issue Year 2023 Volume: 7 Issue: 1

Cite

Vancouver Ipek Y, Yılmaz G. Factors associated with unresponsiveness to treatment in patients with non-Hodgkin lymphoma: 10 years of experience from a single center. Acta Med. Alanya. 2023;7(1):66-80.

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