Mantle Hücreli Lenfoma Hastalarımızın Klinik ve Laboratuvar Özellikleri: Kesitsel Bir Çalışma

Yıl 2021, , 56 - 61, 20.01.2021

Nur Oguz Davutoglu , Eren Gunduz , Hava Üsküdar Teke , Neslihan Andıc

https://doi.org/10.20515/otd.759341

Öz

Mantle hücreli lenfoma (MHL), Hodgkin dışı lenfoma vakalarının %10’dan daha azını oluşturur. Başlıca bağımsız risk faktörleri; MHL Uluslararası Prognostik İndeksi (MIPI) ve Ki-67 tümör proliferasyonu indeksidir. Bu çalışmanın amacı; bölümümüzde takip ve tedavisi yapılan MHL hastalarının geriye dönük olarak değerlendirilmesidir. Çalışmaya tıbbi kayıtlarına ulaşılabilen toplam 27 MHL hastası dahil edildi. Bu veriler incelenerek hastaların, MIPI skoru, kemik iliği tutulumu, ekstranodal tutulum, tedavi protokolleri, tedaviye yanıtı, nüks durumu ve nakil öyküsü kaydedildi. Bulgular: Hastalar ortalama 64,4 (1-246) ay süreyle takip edilmişti. Hastaların 5’ine (%18) otolog, 2’sine (%8) allogeneik hematopoietik kök hücre nakli yapılmıştı. Birinci basamak tedavi sonrası 17 (%63) hastada tam yanıt, 3 (%11) hastada kısmi yanıt elde edilirken 7 (%26) hastada progresyon saptandı. Birinci basamak tedavi sonrası medyan progresyonsuz sağkalım 29 (3-120) ay olarak hesaplandı. MIPI skorlamasına göre düşük riskli hasta grubunun medyan sağkalımı, yüksek riskli hasta grubuna göre daha uzun (194 ay vs 126 ay, p=0.04), orta riskli hasta grubunun progresyonsuz sağkalımı yüksek riskli hasta grubuna göre daha uzun (41 ay vs 3 ay, p=0.025) bulundu. Sonuç olarak, çalışmamızda hastaların medyan tanı yaşı, çoğunun evre III-IV olması, MIPI skoru yüksek hastalarda progresyonsuz sağkalımın kısa olması literatürle uyumlu bulgular olarak saptandı. Merkezimizde en çok tercih edilen birinci basamak tedavi R-hyper-CVAD/MTX-AraC olup literatüre kıyasla medyan progresyonsuz sağ kalım süresi daha kısa bulundu. MHL’de giderek artan hedefe yönelik tedavi kullanımı dikkate alındığında, bu tür tedavilerle eskiden beri mevcut olan tedavilerin kıyaslanması açısından sonuçlarımızın önemli olduğu kanaatindeyiz.

Anahtar Kelimeler

Mantle hücreli lenfoma, tedavi, prognoz

Clinical and Laboratory Characteristics of Our Mantle Cell Lymphoma Patients: A Cross Sectional Study

Öz

Mantle cell lymphoma (MCL) comprises less than 10% of non-Hodgkin's lymphoma cases. Major independent risk factors are identified as the MCL International Prognostic Index (MIPI) and Ki-67 proliferation index of tumor. The aim of this study is retrospectively evaluate MCL patients treated and followed-up in our department. Materials and Methods: This study included 27 MCL patients medical records of whom could be reached. The data was reviewed to figure out MIPI score, bone marrow involvement, extranodal involvement, treatment protocols, treatment response, relapse status, and transplant history. Patients were followed-up for a mean duration of 64.4 (1-246) months. Subsequent to the first-line treatment, complete response was achieved in 17 (63%) and partial response was achieved in 3 (11%) patients, whereas 7 (26%) patients experienced disease progression. Median PFS following first-line treatment was 29 (3-120) months. Based on the classification by MIPI scoring, low-risk patients had significantly longer median survival than that of high-risk patients (194 months vs 126 months, p=0.04), and the patients at moderate-risk had significantly longer PFS compared to high-risk patients (41month vs 3 months, p=0.025). Median age, stage III-IV, and short duration of PFS in patients with high MIPI score were our findings in parallel with available literature. R-hyper-CVAD/MTX-AraC was mostly preferred first-line treatment at our center with a shorter median PFS compared to literature. Given the expanding use of target-driven therapies for MCL, we believe our results are noteworthy in comparing such therapies with pre-existing therapies.

Anahtar Kelimeler

Mantle cell lymphoma, treatment, prognosis

Kaynakça

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