Journals / Uluslararası Hematoloji-Onkoloji Dergisi / 2006 / Cilt: 16 - Sayı: 4
The evaluation of the clinical features of patients with non-Hodgkin lymphoma
- Pages
- 185–194
- DOI
- —
Abstract
The clinical features, histopathological types, treatment modalities and response, and survival analysis were evaluated in our 114 patients with non-Hodgkin lymphoma (NHL). At initial diagnosis, 10% had stage I, 14% stage II, 30% stage III, and 46% stage IV disease according to Cotswold classification. Therapy was administered to 101 (89%) NHL subjects at initial diagnosis. CHOP was given to 57 (56%) and rituximab (R)-CHOP to 17 (17%) cases. The highest rate of complete remission was in R-CHOP group (83%). The median survival of NHL subjects was 52 months. 3-year survival was 54%, 5-year survival was 46%. Survival of very aggressive lymphoma patients (3 months) was shorter than that of aggressive (41 months) and indolent (86 months) patients (p values<0.05). The median survival of stage IV subjects at initial diagnosis (26 months) was shorter than stage I (not reached), stage II (86 months) and stage III (96 months) cases (p values <0.05). Survival of patients with B symptoms, extranodal and bone marrow involvement, unresponsive to first-line therapy, IPI> 2 at initial diagnosis was shorter than others (p values <0.05). Cox regression analysis showed that unresponsiveness to first-line therapy (OR:11.6, p=0.001) was an independent poor prognostic factor. It was interesting that combined chemotherapy with rituximab achieved a high rate of complete remission when given as first-line therapy.
Özet
Non-Hodgkin lenfomalı (NHL) 114 hastamızın klinik özellikleri, histopatolojik tipleri, tedavileri ve yanıtları, ve sağkalım analizi değerlendirildi. Tanıda Cotswold’a göre %10’u evre I, %14’ü evre II, %30’u evre III ve %46’sı evre IV’tü. Olguların 101’ine (%89) tedavi uygulandı. 57 olguda (%56) CHOP ve 17 olguda (%17) rituksimab (R)-CHOP verildi. En yüksek tam remisyon oranı R-CHOP grubundaydı (%83). Hastaların medyan sağkalımı 52 aydı. 3 yıllık sağkalım %54, 5 yıllık sağkalım %46 idi. Çok agresif NHL’lilerin sağkalımı (3 ay), agresif (41 ay) ve indolentlerden (86 ay) kısaydı (p’ler 2 olanların sağkalımları diğerlerinden kısaydı (p’ler<0.05). Cox regresyon analizinde, ilk tedaviye cevapsızlığın (OR:11.6, p=0.001) bağımsız kötü prognostik faktör olduğu saptandı. İlk tedavide rituksimablı kombine kemoterapiyle yüksek tam remisyon oranı dikkat çekiciydi.