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Türkiye'nin doğusunda non-Hodgkin lenfoma hastalarının klinik ve patolojik özellikleri

Year 2020, Volume: 45 Issue: 2, 533 - 540, 30.06.2020
https://doi.org/10.17826/cumj.672199

Abstract

Amaç: Bu çalışmada non-Hodgkin lenfoma (NHL) hastalarının epidemiyolojik, demografik, klinik ve prognostik özelliklerini araştırmayı amaçladık.
Gereç ve Yöntem: İnönü Üniversitesi Tıp Fakültesi Hematoloji kliniğinde 2000 ile 2016 yılları arasında NHL tanısı ile takipli hastalar çalışmaya alındı. Çalışmaya 18 yaşından büyük hastalar dâhil edildi. Hasta özellikleri, kayıtlar retrospektif olarak gözden geçirilerek değerlendirildi.
Bulgular: Çalışmaya alınan 386 hastanın 242’si (%62.7) erkek, 144’ü (%37.3) kadın, ve tüm hastalarda ortanca yaş 53 idi. En sık NHL alt tipi Diffüz Büyük B Hücreli Lenfoma (DBBHL) (46.9) idi. Tek değişkenli analizde, hastaların ileri evrede (Evre III-IV) olması, IPI skoruna göre yüksek-orta ve yüksek riskli kategoride olması, kemik iliği tutulumu olması, hemoglobin düzeyinin 10 gr/dl’nin altında olması, LDH düzeyinin normalin üzerinde olması, primer tutulumunun nodal olması, B semptomların varlığı, otolog kemik iliği yapılması zorunluluğu ve birincil tedavi olarak rituximab bazlı kemoterapi rejimlerini almaması daha kısa genel sağkalım ile ilişkili bulundu.
Sonuç: NHL hastalığının insidansı, klinik özellikleri, histopatolojik alt tipleri, tedavi yanıtları ve genel sağkalım oranları coğrafi bölgelere göre farklılıklar gösterebilmektedir. Bu nedenle tedavi hastalık alt tip dağılımına göre bireyselleştirilmelidir.

References

  • Beers MH, Berkow R (eds), The Merck Manual of Diagnosis and Therapy. 17th ed. Merck &Co, 2002:1002-1015-2547.
  • Jiang M, Bennani NN, Feldman AL. Lymphoma classification update: T-cell lymphomas, Hodgkin lymphomas, and histiocytic/dendritic cell neoplasms. Expert Rev Hematol. 2017;10:239-49.
  • Armitage JO, Gascoyne RD, Lunning MA, Cavalli F. Non-Hodgkin lymphoma. Lancet. 2017;390:298-310.
  • Quintanilla-Martinez L. The 2016 updated WHO classification of lymphoid neoplasias. Hematol Oncol. 2017;35:37-45.
  • Newton R, Ferlay J, Beral V. The epidemiology of non-Hodgkin’s lymphoma: comparison of nodal and extra-nodal sites. Int J Cancer. 1997;72:923-30.
  • Lim ST, Levine AM. Recent advances in acquired immunodeficiency syndrome (AIDS)-related lymphoma. CA Cancer J Clin. 2009;55:229-41.
  • Shankland KR, Armitage JO, Hancock BW. Non-Hodgkin lymphoma. Lancet. 2012;380:848-57.
  • Pfreundschuh M. How I treat elderly patients with diffuse large B-cell lymphoma. Blood. 2010;116:5103-10.
  • Armitage JO. Staging non-Hodgkin lymphoma. CA Cancer J Clin. 2005;55:368-76.
  • Yang Y, Wang L, Ma Y, Han T, Huang M. The Enhanced International Prognostic Index for Diffuse Large B-cell Lymphoma. Am J Med Sci. 2017;353:459-65.
  • Martelli M, Ferreri AJ, Agostinelli C, Di Rocco A, Pfreundschuh M, Pileri SA. Diffuse large B cell lymphoma. Crit Rev Oncol Hematol. 2013;87:146-71.
  • Swerdlow SH, Campo E, Pileri SA, Harris NL, Stein H, Siebert R,et al. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood. 2016;127:2375-90.
  • Oken, MM, Creech, RH, Tormey, DC. Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol. 1982;5:649-55.
  • Chan JKC. The New World Health Organization classification of lymphomas: the past, the present and the future. Hematol Oncol. 2001;19:129-50.
  • Castella A, Joshi S, Raaschou T. Pattern of malignant lymphoma in the United Arab Emirates: a histopathologic and immunologic study in 208 native patients. Acta Oncol. 2001;40:660-4.
  • Kim HY, Jang MA, Kim HJ, Kim SJ, Kim WS, Kim SH. Clinical impact of CD5 expression in Korean patients with diffuse large B-cell lymphoma. Blood Res. 2017;52:193-9.
  • Cartwright R, Brincker H, Carli PM. et al. The rise in incidence of lymphomas in Europe 1985-1992. Eu J. Cancer. 1999;35:627-33.
  • Gisselbrecht C, Van Den Neste E. How I manage patients with relapsed/refractory diffuse large B cell lymphoma. Br J Haematol. 2018;182:633-43.
  • Işıkdoğan A, Ayyıldız O, Büyükçelik O, et al. Non-Hodgkin’s lymphoma in southeast Turkey; clinicopathologic features of 490 cases. Ann Hematology 2004;83 265-9.
  • Pamuk GE, Harmandar F, Harmandar O, et al. Evalulation of clinical characteristics of cases of non-Hodgkin lymphoma. Int J Hematol Oncol 2006;4: 185-94.
  • Armitage JO. The aggressive peripheral T-cell lymphomas: 2015. Am J Hematol. 2015;90:665-73.
  • Shipp MA, Harrington DP, Anderson JR, et al. International Non-Hodgkin’s Lymphoma Prognostic factors Project. A Predictive model for aggressive non-Hodgkin’s lymphoma. N Engl J Med 1993;329:987-94.
  • Altekruse SF, Kosary CL, Krapcho M, et al. SEER Cancer Statistics Review, 1975- 2007. National Cancer Institute. 2009:85-111.
  • Morrison VA, Shou Y, Bell JA, Hamilton L, Ogbonnaya A, Raju A, et al. Evaluation of treatment patterns and survival among patients with diffuse large B-cell lymphoma in the USA. Future Oncol. 2019;15:1021-34. Galaznik A, Huelin R, Stokes M, Guo Y, Hoog M, Bhagnani T, et al. Systematic review of therapy used in relapsed or refractory diffuse large B-cell lymphoma and follicular lymphoma. Future Sci OA. 2018;4:FSO322.
  • Liu Y, Barta SK. Diffuse Large B cell Lymphoma: 2019 update on diagnosis, risk-stratification and treatment. Am J Hematol. 2019 Mar 11.
  • Alıcı S, Bavbek S, Kaytan E. Aggressive non-Hodgkin’s Lymphoma treated at the Institute of Oncology, Istanbul: treatment, outcome, and prognostic factors. Am J Clin Oncol. 2002;25:502-8.
  • Lippman SM, Miller TP Spier CM, Slymen DJ. The prognostic significance of the imminotype in diffuse large-cell lymphoma. A comporative study of the T-cell and B-cell phenotype. Blood 1988:72;436-41.
  • Zing NPC, Fischer T, Zain J, Federico M, Rosen ST. Peripheral T-Cell Lymphomas: Incorporating New Developments in Diagnostics, Prognostication, and Treatment Into Clinical Practice-PART 2: ENKTL, EATL, Indolent T-Cell LDP of the GI Tract, ATLL, and Hepatosplenic T-Cell Lymphoma. Oncology (Williston Park). 2018;32:e83-e89.

Clinical and pathological characteristics of patients with non-Hodgkin lymphoma cases in Eastern Turkey

Year 2020, Volume: 45 Issue: 2, 533 - 540, 30.06.2020
https://doi.org/10.17826/cumj.672199

Abstract

Purpose: This study aims to evaluate the epidemiological, demographic and clinical characteristics, and prognostic factors of the patients with non-Hodgkin lymphomas (NHL).
Materials and Methods: All patients diagnosed with NHL at the Department of Hematology of Inonu University Faculty of Medicine (Turkey) between 2000 and 2016 were evaluated for this study. Only patients older than 18 years were included in the study. Characteristics were evaluated by reviewing patients’ records retrospectively.
Results: Of the 386 patients studied, 242 (62.7%) were male and 144 (37.3%) were female and the overall median age was 53 years (range: 18–92). The most common histological subtype of NHL was diffuse large B-cell lymphoma (DLBCL) (46.9%). In univariate analyses, advanced stage (III-IV), high-intermediate to high risk category disease based on IPI score, bone marrow involvement at diagnosis, haemoglobin levels below 10 g/dL, increased LDH levels, primary nodal involvement, the presence of B symptoms, the exigency of autologous bone marrow transplant, and not receiving rituximab-based chemotherapy regimens as the primary treatment were all associated with shorter overall survival.
Conclusion: The prevalence, clinical characteristics, histopathological subtypes, treatment responses, and overall survival rates may differ because NHL is a heterogeneous disease group and may vary according to a geographical area. Therefore, treatment should be individualized according to disease subtype.

References

  • Beers MH, Berkow R (eds), The Merck Manual of Diagnosis and Therapy. 17th ed. Merck &Co, 2002:1002-1015-2547.
  • Jiang M, Bennani NN, Feldman AL. Lymphoma classification update: T-cell lymphomas, Hodgkin lymphomas, and histiocytic/dendritic cell neoplasms. Expert Rev Hematol. 2017;10:239-49.
  • Armitage JO, Gascoyne RD, Lunning MA, Cavalli F. Non-Hodgkin lymphoma. Lancet. 2017;390:298-310.
  • Quintanilla-Martinez L. The 2016 updated WHO classification of lymphoid neoplasias. Hematol Oncol. 2017;35:37-45.
  • Newton R, Ferlay J, Beral V. The epidemiology of non-Hodgkin’s lymphoma: comparison of nodal and extra-nodal sites. Int J Cancer. 1997;72:923-30.
  • Lim ST, Levine AM. Recent advances in acquired immunodeficiency syndrome (AIDS)-related lymphoma. CA Cancer J Clin. 2009;55:229-41.
  • Shankland KR, Armitage JO, Hancock BW. Non-Hodgkin lymphoma. Lancet. 2012;380:848-57.
  • Pfreundschuh M. How I treat elderly patients with diffuse large B-cell lymphoma. Blood. 2010;116:5103-10.
  • Armitage JO. Staging non-Hodgkin lymphoma. CA Cancer J Clin. 2005;55:368-76.
  • Yang Y, Wang L, Ma Y, Han T, Huang M. The Enhanced International Prognostic Index for Diffuse Large B-cell Lymphoma. Am J Med Sci. 2017;353:459-65.
  • Martelli M, Ferreri AJ, Agostinelli C, Di Rocco A, Pfreundschuh M, Pileri SA. Diffuse large B cell lymphoma. Crit Rev Oncol Hematol. 2013;87:146-71.
  • Swerdlow SH, Campo E, Pileri SA, Harris NL, Stein H, Siebert R,et al. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood. 2016;127:2375-90.
  • Oken, MM, Creech, RH, Tormey, DC. Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol. 1982;5:649-55.
  • Chan JKC. The New World Health Organization classification of lymphomas: the past, the present and the future. Hematol Oncol. 2001;19:129-50.
  • Castella A, Joshi S, Raaschou T. Pattern of malignant lymphoma in the United Arab Emirates: a histopathologic and immunologic study in 208 native patients. Acta Oncol. 2001;40:660-4.
  • Kim HY, Jang MA, Kim HJ, Kim SJ, Kim WS, Kim SH. Clinical impact of CD5 expression in Korean patients with diffuse large B-cell lymphoma. Blood Res. 2017;52:193-9.
  • Cartwright R, Brincker H, Carli PM. et al. The rise in incidence of lymphomas in Europe 1985-1992. Eu J. Cancer. 1999;35:627-33.
  • Gisselbrecht C, Van Den Neste E. How I manage patients with relapsed/refractory diffuse large B cell lymphoma. Br J Haematol. 2018;182:633-43.
  • Işıkdoğan A, Ayyıldız O, Büyükçelik O, et al. Non-Hodgkin’s lymphoma in southeast Turkey; clinicopathologic features of 490 cases. Ann Hematology 2004;83 265-9.
  • Pamuk GE, Harmandar F, Harmandar O, et al. Evalulation of clinical characteristics of cases of non-Hodgkin lymphoma. Int J Hematol Oncol 2006;4: 185-94.
  • Armitage JO. The aggressive peripheral T-cell lymphomas: 2015. Am J Hematol. 2015;90:665-73.
  • Shipp MA, Harrington DP, Anderson JR, et al. International Non-Hodgkin’s Lymphoma Prognostic factors Project. A Predictive model for aggressive non-Hodgkin’s lymphoma. N Engl J Med 1993;329:987-94.
  • Altekruse SF, Kosary CL, Krapcho M, et al. SEER Cancer Statistics Review, 1975- 2007. National Cancer Institute. 2009:85-111.
  • Morrison VA, Shou Y, Bell JA, Hamilton L, Ogbonnaya A, Raju A, et al. Evaluation of treatment patterns and survival among patients with diffuse large B-cell lymphoma in the USA. Future Oncol. 2019;15:1021-34. Galaznik A, Huelin R, Stokes M, Guo Y, Hoog M, Bhagnani T, et al. Systematic review of therapy used in relapsed or refractory diffuse large B-cell lymphoma and follicular lymphoma. Future Sci OA. 2018;4:FSO322.
  • Liu Y, Barta SK. Diffuse Large B cell Lymphoma: 2019 update on diagnosis, risk-stratification and treatment. Am J Hematol. 2019 Mar 11.
  • Alıcı S, Bavbek S, Kaytan E. Aggressive non-Hodgkin’s Lymphoma treated at the Institute of Oncology, Istanbul: treatment, outcome, and prognostic factors. Am J Clin Oncol. 2002;25:502-8.
  • Lippman SM, Miller TP Spier CM, Slymen DJ. The prognostic significance of the imminotype in diffuse large-cell lymphoma. A comporative study of the T-cell and B-cell phenotype. Blood 1988:72;436-41.
  • Zing NPC, Fischer T, Zain J, Federico M, Rosen ST. Peripheral T-Cell Lymphomas: Incorporating New Developments in Diagnostics, Prognostication, and Treatment Into Clinical Practice-PART 2: ENKTL, EATL, Indolent T-Cell LDP of the GI Tract, ATLL, and Hepatosplenic T-Cell Lymphoma. Oncology (Williston Park). 2018;32:e83-e89.
There are 28 citations in total.

Details

Primary Language English
Subjects Haematology
Journal Section Research
Authors

Ali Dogan 0000-0003-0207-3505

Narin Yıldırım Doğan 0000-0001-6742-7090

Mehmet Ali Erkurt 0000-0002-3285-417X

Ömer Ekinci 0000-0002-4636-3590

İrfan Kuku 0000-0001-6126-0816

Emin Kaya 0000-0001-8605-8497

Publication Date June 30, 2020
Acceptance Date March 25, 2020
Published in Issue Year 2020 Volume: 45 Issue: 2

Cite

MLA Dogan, Ali et al. “Clinical and Pathological Characteristics of Patients With Non-Hodgkin Lymphoma Cases in Eastern Turkey”. Cukurova Medical Journal, vol. 45, no. 2, 2020, pp. 533-40, doi:10.17826/cumj.672199.