Army Hospital Research and Referral, New Delhi.
J Assoc Physicians India. 2022 Apr;70(4):11-12.
The aim and objectives are to study clinicopathological profiles and 2-year relapse rates of Non-Hodgkin lymphoma,Material :This prospective observational study was conducted from Jan 2017 to May 2021. All newly diagnosed patients of NHL were enrolled and received a CHOP±R regimen for 6 cycles as per B-cell or T-cell lineage. The data was and analyzed using spss software. Observation: A total of 50 patients were enrolled and followed for 2 years. The median age of presentation was 44.62±15.92. Commonest clinical presentation was lymphadenopathy (46%), followed by B symptoms (32%). Commonest clinical sign was lymph node enlargement (52%). The commonest extranodal presentation was hepatomegaly (22%) and splenomegaly (22%). On peripheral blood smear, macrocytic hypochromic anemia (12%) was the commonest presentation. CT Scan showed, nodal involvement in 86% with generalized lymphadenopathy in (40%) cases. Extranodal involvement was seen in 50%. WB PET showed nodal involvement in (90%), and extranodal involvement in 70%. PET scan (90%) was a little more sensitive for detecting lymph node involvement over CT scan (86%). On lymph node biopsy, the most common subtype was B cell NHL (84.84%) and the commonest histopathological subtype was diffuse large cell B cell lymphoma. Biopsy from the extranodal site shown B cell NHL in (93.33%). The commonest histopathological subtype was DLBCL (18%). On marrow examination and biopsy, 88% were B cell type and the commonest type was DLBCL (62%). The commonest treatment-related toxicity was febrile neutropenia (44%). At 6 months, 30% were having clinical active disease and PET imaging revealed radiologic disease activity in 32 %. At 12 months, 14% were having clinical disease, and radiologic disease activity in 14%. At 18 months, 5% were having clinical disease, and radiologic disease activity in 10%. At 24 months, 14% were having clinical disease, and radiologic disease activity in 14%. At the end of the study period, 78 % were in remission, 10% cases in relapse, 6% cases had progressive disease and 6% of cases expired. Conclusion: This study found 02-year survival post standard chemotherapy in NHL cases was 88%. The relapse rate at 24 months was 14%. The B symptoms were seen less commonly, and bulky disease was noted in one-third of cases. The role of PET in diagnosing and follow up on these cases was good but it was comparable with CT scan.
目的和目标是研究非霍奇金淋巴瘤的临床病理特征和 2 年复发率。
本前瞻性观察性研究于 2017 年 1 月至 2021 年 5 月进行。所有新诊断的 NHL 患者均入组,并根据 B 细胞或 T 细胞谱系接受 6 个周期的 CHOP±R 方案。使用 spss 软件对数据进行分析。
共纳入 50 例患者,并随访 2 年。中位发病年龄为 44.62±15.92。最常见的临床表现为淋巴结病(46%),其次为 B 症状(32%)。最常见的临床体征为淋巴结肿大(52%)。最常见的结外表现为肝肿大(22%)和脾肿大(22%)。外周血涂片显示,巨红细胞低色素性贫血(12%)最为常见。CT 扫描显示 86%有淋巴结受累,40%有全身淋巴结病。50%有结外受累。WB PET 显示淋巴结受累(90%),结外受累(70%)。PET 扫描(90%)对检测淋巴结受累比 CT 扫描(86%)更敏感。淋巴结活检显示,最常见的亚型为 B 细胞 NHL(84.84%),最常见的组织病理学亚型为弥漫性大细胞 B 细胞淋巴瘤。结外部位活检显示 B 细胞 NHL(93.33%)。最常见的组织病理学亚型为 DLBCL(18%)。骨髓检查和活检显示,88%为 B 细胞类型,最常见的类型为 DLBCL(62%)。最常见的治疗相关毒性为发热性中性粒细胞减少症(44%)。6 个月时,30%有临床活动性疾病,PET 成像显示 32%有放射学疾病活动。12 个月时,14%有临床疾病,14%有放射学疾病活动。18 个月时,5%有临床疾病,10%有放射学疾病活动。24 个月时,14%有临床疾病,14%有放射学疾病活动。研究结束时,78%的患者处于缓解期,10%的患者复发,6%的患者疾病进展,6%的患者死亡。
本研究发现 NHL 患者在接受标准化疗后 2 年的生存率为 88%。24 个月时的复发率为 14%。B 症状较少见,三分之一的病例有肿块性疾病。PET 在这些病例的诊断和随访中的作用很好,但与 CT 扫描相当。