Abstract
Aim: The aim of this study is to share
our experience on long-term outcomes by analysing the epidemiological,
histomorphologic characteristics, treatment response rates and survival data of
lymphoma patients in our center.
Material and Method: 228 patients admitted to our
center between 2009-2017 and diagnosed with lymphoma were reviewed retrospectively
based on the diagnostic subgroups indicated in the revision of the World Health
Organization (WHO) classification of 2016. Demographic data and disease rates
were analyzed to determine response rates, Overall and Progression-free
survival rates.
Results: During the 8-year study period,
among 228 patients diagnosed with lymphoma, 190 patients were Non-Hodgkin's Lymphoma
(NHL) and 38 patients were Hodgkin's Lymphoma (HL). 135 patients were
classified as aggressive NHL, 55 as indolent NHL and 38 as HL. Of the total 190
NHL cases, 178 (93.7%) were of B cell origin and 12 (6,3%) were of T cell
origin. DBBHL (49.5%) was the most common subtype. The median follow-up time
was 22.23 ± 20.74 months. Overall survival (OS) was 49.94 months and
progression-free survival (PFS) was 49.54 months in aggressive NHL patients. OS
in indolent NHL patients was found to be 63.78 months and PFS was 64.31 months.
In HL patients, OS was 62.92 months and PFS was 62.92 months. Complete blood
count parameters, ferritin and vitamin B12 levels have no effect on OS and PFS (p>
0.05).
Conclusion: Epidemiology, subtypes
distribution, response rates and survival data of lymphoma patients in our
centre, was found to be partially similar to the data of Turkey and developing
countries. Complete blood count parameters did not appear to have any effect on
survival rates. More studies are needed to find new developments and different
prognostic markers that may have a positive impact on survival, especially in
aggressive NHL patients.
Keywords
References
- Chuang SS, Chen SW, Chang ST, et al. Lymphoma in Taiwan: Review of 1347 neoplasms from a single institution according to the 2016 Revision of the World Health Organization Classification. Journal of the Formosan Medical Association. 2017; 116: 620-625.
- Perry AM, Diebold J, Nathwani BN, et al. Non-Hodgkin lymphoma in the developing world: review of 4539 cases from the International Non-Hodgkin Lymphoma Classification Project. Haematologica. 2016; 101: 1244-1250.
- Vardiman JW, Thiele J, Arber DA, et al. The 2008 revision of the World Health Organization (WHO) classification of myeloid neoplasms and acute leukemia: rationale and important changes. Blood. 2009; 114: 937-51.
- Swerdlow SH, Campo E, Pileri SA, et al. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood. 2016; 127: 2375-90.
- Türk Hematoloji Derneği Ulusal Tanı ve Tedavi Kılavuzu. Lenfoma Tanı ve Tedavi Kılavuzu. İstanbul:Galenos Yayınevi;2016.
- Parkin DM, Bray F, Ferlay J, et al. Estimating the world cancer burden: Globocan 2000. International journal of cancer. 2001; 94: 153-6.
- Cartwright R, Brincker H, Carli PM, et al. The rise in incidence of lymphomas in Europe 1985-1992. European journal of cancer. 1999; 35: 627-33.
- Lenfoma Rapor Bülteni. İstatistik, Analiz ve Raporlama Daire Başkanlığı. www.tkhk.gov.tr 10.09.2015.
- Roman E, Smith AG. Epidemiology of lymphomas. Histopathology. 2011; 58: 4-14.
- Yagci-Kupeli B, Akyuz C, Yalcin B, et al. Single institution experience on cancer among adolescents 15-19 years of age. The Turkish journal of pediatrics. 2017; 59: 1-5.
- Armitage JO, Weisenburger DD. New approach to classifying non-Hodgkin's lymphomas: clinical features of the major histologic subtypes. Non-Hodgkin's Lymphoma Classification Project. Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 1998; 16: 2780-95.
- Beham-Schmid C. Aggressive lymphoma 2016: revision of the WHO classification. Memo. 2017; 10: 248-254.
- Al-Hamadani M, Habermann TM, Cerhan JR, et al. Non-Hodgkin lymphoma subtype distribution, geodemographic patterns, and survival in the US: A longitudinal analysis of the National Cancer Data Base from 1998 to 2011. American journal of hematology. 2015; 90: 790-5.
- Smith A, Crouch S, Lax S, et al. Lymphoma incidence, survival and prevalence 2004-2014: sub-type analyses from the UK's Haematological Malignancy Research Network. British journal of cancer. 2015; 112: 1575-84.
- Miura Y, Fukuhara N, Yamamoto J, et al. Clinicopathological features of malignant lymphoma in Japan: the Miyagi Study. The Tohoku journal of experimental medicine. 2011; 224: 151-60.
- Beddhu S, Bruns FJ, Saul M, et al. A simple comorbidity scale predicts clinical outcomes and costs in dialysis patients. The American journal of medicine. 2000; 108: 609-13.
- Kasamon YL, Jacene HA, Gocke CD, et al. Phase 2 study of rituximab-ABVD in classical Hodgkin lymphoma. Blood. 2012; 119: 4129-32.
Abstract
Amaç: Bu çalışmanın amacı, merkezimize
başvuran lenfoma hastalarının epidemiyolojik, histomorfolojik özelliklerini,
tedaviye yanıt oranlarını ve sağkalım verilerini inceleyerek, uzun vadeli
sonuçlar hakkında deneyimimizi paylaşmaktır.
Gereç ve Yöntem: 2009-2017 yılları arasında
merkezimize başvuran ve lenfoma tanısı konulan 228 hasta, Dünya Sağlık Örgütü
(WHO) sınıflamasının 2016 revizyonunda belirtilen tanı grupları baz alınarak
retrospektif olarak incelendi. Demografik veriler ve hastalık verileri
incelenerek yanıt oranları, genel ve hastalıksız sağkalım oranları hesaplandı.
Bulgular: 8 yıllık çalışma süresi boyunca
228 lenfoma tanısı alan hastadan 190 hasta Non-Hodgkin Lenfoma (NHL), 38 hasta Hodgkin
Lenfoma (HL) idi. 135 hasta agresif NHL, 55 hasta indolent NHL ve 38 hasta HL
olarak gruplandırıldı. Toplam 190 NHL olgularının 178'i (%93.7) B hücre
kaynaklı, 12'si (%6,3) T hücre kaynaklı idi. DBBHL (%49.5) en sık görülen
alttip idi. Medyan takip süresi 22.23±20.74 ay olarak bulundu. Agresif NHL
hastalarında genel sağkalım (OS) 49.94 ay, hastalıksız sağkalım (PFS) 49.54 ay
olarak bulunmuştur. İndolen NHL hastalarında OS 63.78 ay, PFS 64.31 ay olarak
bulunmuştur. HL hastalarında OS 62.92 ay, PFS 62.92 ay olarak bulunmuştur. Hastaların tanı anındaki tam kan sayımı
parametrelerinin, ferritin ve vitamin B12 düzeylerinin sağkalım sürelerine
etkisi olmadığı görülmüştür (p>0.05).
Sonuçlar:
Merkezimizin
lenfoma epidemiyolojisi, histopatolojik alt tip dağılımı, yanıt oranları ve
sağkalım verilerinin, Türkiye ve gelişmekte olan ülke verilerine kısmen benzer
olduğu görülmüştür. Tam kan sayımı parametrelerinin sağkalım üzerine etkisi
olmadığı görülmüştür. Özellikle agresif NHL hastalarında sağkalım sürelerine
olumlu etki sağlayabilecek yeni gelişmeler ve farklı prognostik belirteçler
bulunması için daha fazla çalışmaya ihtiyaç duyulmaktadır.
Keywords
References
- Chuang SS, Chen SW, Chang ST, et al. Lymphoma in Taiwan: Review of 1347 neoplasms from a single institution according to the 2016 Revision of the World Health Organization Classification. Journal of the Formosan Medical Association. 2017; 116: 620-625.
- Perry AM, Diebold J, Nathwani BN, et al. Non-Hodgkin lymphoma in the developing world: review of 4539 cases from the International Non-Hodgkin Lymphoma Classification Project. Haematologica. 2016; 101: 1244-1250.
- Vardiman JW, Thiele J, Arber DA, et al. The 2008 revision of the World Health Organization (WHO) classification of myeloid neoplasms and acute leukemia: rationale and important changes. Blood. 2009; 114: 937-51.
- Swerdlow SH, Campo E, Pileri SA, et al. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood. 2016; 127: 2375-90.
- Türk Hematoloji Derneği Ulusal Tanı ve Tedavi Kılavuzu. Lenfoma Tanı ve Tedavi Kılavuzu. İstanbul:Galenos Yayınevi;2016.
- Parkin DM, Bray F, Ferlay J, et al. Estimating the world cancer burden: Globocan 2000. International journal of cancer. 2001; 94: 153-6.
- Cartwright R, Brincker H, Carli PM, et al. The rise in incidence of lymphomas in Europe 1985-1992. European journal of cancer. 1999; 35: 627-33.
- Lenfoma Rapor Bülteni. İstatistik, Analiz ve Raporlama Daire Başkanlığı. www.tkhk.gov.tr 10.09.2015.
- Roman E, Smith AG. Epidemiology of lymphomas. Histopathology. 2011; 58: 4-14.
- Yagci-Kupeli B, Akyuz C, Yalcin B, et al. Single institution experience on cancer among adolescents 15-19 years of age. The Turkish journal of pediatrics. 2017; 59: 1-5.
- Armitage JO, Weisenburger DD. New approach to classifying non-Hodgkin's lymphomas: clinical features of the major histologic subtypes. Non-Hodgkin's Lymphoma Classification Project. Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 1998; 16: 2780-95.
- Beham-Schmid C. Aggressive lymphoma 2016: revision of the WHO classification. Memo. 2017; 10: 248-254.
- Al-Hamadani M, Habermann TM, Cerhan JR, et al. Non-Hodgkin lymphoma subtype distribution, geodemographic patterns, and survival in the US: A longitudinal analysis of the National Cancer Data Base from 1998 to 2011. American journal of hematology. 2015; 90: 790-5.
- Smith A, Crouch S, Lax S, et al. Lymphoma incidence, survival and prevalence 2004-2014: sub-type analyses from the UK's Haematological Malignancy Research Network. British journal of cancer. 2015; 112: 1575-84.
- Miura Y, Fukuhara N, Yamamoto J, et al. Clinicopathological features of malignant lymphoma in Japan: the Miyagi Study. The Tohoku journal of experimental medicine. 2011; 224: 151-60.
- Beddhu S, Bruns FJ, Saul M, et al. A simple comorbidity scale predicts clinical outcomes and costs in dialysis patients. The American journal of medicine. 2000; 108: 609-13.
- Kasamon YL, Jacene HA, Gocke CD, et al. Phase 2 study of rituximab-ABVD in classical Hodgkin lymphoma. Blood. 2012; 119: 4129-32.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Original article |
| Authors | |
| Publication Date | September 30, 2018 |
| Published in Issue | Year 2018 Volume: 10 Issue: 3 |
e-ISSN: 2548-0251
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