Clinicopathologic features and prognostic factors of non-Hodgkin's lymphomas: Experience with 164 cases

SUMMARY Clinicopathologic Features and Prognostic Factors of Non- Hodgkin's Lymphomas : Experience with 164 Cases Güneş, A Jini Department of Internal Medicine, School of Medicine, Dokuz Eylül University İzmir Address for correspondence: DEUTF İç Hastalıkları A.D. İnciraltı/ İzmir 35340 Turkey E-mail: ayse.gunes@deu.edu.tr Aim: Non-Hodgkin Lymphomas (NHL) are defined as lymphopoietic malignancies of B cells, T cells, or natural killer cells. The incidence of Non-Hodgkin Lymphomas varies by age, geography, ethnicity, exposure to infectious agents. Primary extranodal lymphomas are more common in Asia and Middle East than Europe and United States of America. The most commonly observed primary extranodal lymphomas are gastrointestinal lymphomas. Most of the patients in USA and western countires were diagnosed in the 6th and 7th decades, in Asia and Middle East were diagnosed in the 4th and 5th decades. The most commonly observed histopathologic type is Diffuse large B-cell lymphoma. The features that reflect the growth and invasive potential of the tumor, anti-tumor response of the patients, and the patient's ability to tolerate intensive therapy are the prognostic factors. In this retrospective study, we aimed to evaluate the clinical characteristics of our NHL patients and factors affected overall and progression free survival in our group of patients. Method: One hundred sixty four NHL patients who had been followed in the Dokuz Eylül University Hematology Department between 1993 and 2005 were included in this study. The medical records of the patients were reviewed retrospectively. Results: The mean age of the patients was 57.34+ 16.1. The most commonly observed histopathologic type was Diffuse large B cell lymphoma followed by periferal T cell and folliculer lymphoma. Primary extranodal lymphomas were 47% of our patients. The most commonly affected extranodal sites were stomach, tonsil and parous. According to the Ann Arbor staging system %40.2 of the patients were stage IV. Based on the IPI scores, 41.5% of the patients were in the low risk group.Five year overall and progression free survival was 74% and 68%. Stage III-IV disease, performans status>2, elevated serum LDH levels, high and high intermediate risk according to IPI, hemoglobin levels below 10 g/dl and nodal disease affected response to therapy, overall and progression free survival. B symptoms and T cell immunophenotype didn't reflect response to therapy, but prolonged overall survivals. Bone marrow and extranodal involvement of lymphoma caused lower therapy response rates, but did not reflect overall and progression free survivals. Age, eritrosit sedimantation rate, CRP and albumin levels didn't statistically significantly affect response to therapy, overall and progression free survival. Conclusion: In this study the disturibition of NHL subtypes was found to be comparable with those reported from Turkey. The extranodal involvement, age, ESR, CRP and serum albumin levels did not significantly affect survival. For a better determination of the facts affecting survival in lymphoma patients, prospective studies evaluating patients having similar pathologic subtypes and clinical features and receiving similar therapies should be planned. Keywords: Non-Hodgkin Lymphoma, Non- Hodgkin Lymphoma in Turkey, prognostic factors, clinicopathologic features, survival