Sengar Manju, Akhade A, Nair R, Menon H, Shet T, Gujral S, Sridhar E, Laskar S, Muckaden M
Department of Medical Oncology, Adult Hematolymphoid Disease Management Group, Tata Memorial Centre, Mumbai, Maharashtra, India.
Indian J Med Paediatr Oncol. 2011 Oct;32(4):197-203. doi: 10.4103/0971-5851.95140.
The uniqueness of adolescent and young adult (AYA) non-Hodgkin lymphomas (NHL) with respect to biology and treatment have largely remained unanswered due to marked heterogeneity in treatment, paucity of prospective, or retrospective studies and poor representation of AYA in clinical trials. This audit attempts to put forward the clinicopathological attributes and treatment outcomes of AYA NHL treated with both pediatric and adult protocols from a single centre in a developing country.
Hospital records of all consecutive NHL patients registered in lymphoma clinic from January 2007 to May 2010 were reviewed for information on demography, clinical features, histology subtype, staging, treatment regimen, response rates, toxicities, and follow up. Two-year progression-free (PFS) and overall survival (OS) were calculated with Kaplan-Meier method.
AYA NHL constituted 4% of all lymphomas. Diffuse large B-cell (DLBL) was the most frequent subtype. Following were the 2-year PFS and OS - DLBL 64%, 76.9%, Burkitt's lymphoma: 56%, 56%, lymphoblastic lymphoma: 33.2%, 44%. Our results did not show any improvement in outcome of DLBL with the use of Burkitt's lymphoma like regimen.
This study highlights some of the key features of AYA NHL occurring in developing world.
由于治疗方法显著异质性、前瞻性或回顾性研究匮乏以及青少年和青年非霍奇金淋巴瘤(AYA NHL)在临床试验中代表性不足,AYA NHL在生物学和治疗方面的独特性在很大程度上仍未得到解答。本审计试图提出一个发展中国家单一中心采用儿科和成人方案治疗的AYA NHL的临床病理特征和治疗结果。
回顾2007年1月至2010年5月在淋巴瘤诊所登记的所有连续性NHL患者的医院记录,以获取人口统计学、临床特征、组织学亚型、分期、治疗方案、缓解率、毒性和随访信息。采用Kaplan-Meier法计算两年无进展生存期(PFS)和总生存期(OS)。
AYA NHL占所有淋巴瘤的4%。弥漫性大B细胞淋巴瘤(DLBL)是最常见的亚型。以下是两年PFS和OS——DLBL分别为64%、76.9%,伯基特淋巴瘤:56%、56%,淋巴母细胞淋巴瘤:33.2%、44%。我们的结果未显示使用类似伯基特淋巴瘤的方案能改善DLBL的预后。
本研究突出了发展中国家AYA NHL的一些关键特征。