Karunakaran Parathan, Selvarajan Gangothri, Kalaiyarasi Jayachandran Perumal, Mehra Nikita, Sundersingh Shirley, Dhanushkodi Manikandan, Kesana Sivasree, Kannan Krishnarathinam, Ganesan Trivadi S, Radhakrishnan Venkatraman, Sagar Tenali Gnana
Department of Medical Oncology, Cancer Institute (WIA), Chennai, India.
Department of Onco-Pathology, Cancer Institute (WIA), Chennai, India.
South Asian J Cancer. 2022 Feb 2;11(1):68-72. doi: 10.1055/s-0041-1739365. eCollection 2022 Jan.
The nomenclature high-grade non-Hodgkin's lymphoma was repurposed in the World Health Organization (WHO) 2016 update as high-grade B cell lymphoma (HGBL). However, among the HGBL entities HGBL, not otherwise specified (NOS) remains a poorly described entity with a lack of literature regarding its treatment and prognosis. The baseline characteristics, treatment, and outcome of HGBL, NOS cases were analyzed. Thirty HGBL, NOS patients were diagnosed between January 2017 and December 2019. Their median age was 49.3 years, and 30% had advanced IPI. The majority received R-CHOP chemotherapy, while five patients received dose-adjusted R-EPOCH. At a median follow-up of 15 months, nine patients had disease progression or relapse. EFS and OS were 22 months (12.1-31.9 months) and 37 months (29.4-44.0 months) respectively. Only NCCN-IPI ≤ 2 showed significant influence on the outcome. The results were similar to the outcomes previously reported. This study highlights the importance of NCCN-IPI in ascertaining the prognosis of HGBL, NOS. The literature review suggests that more intensive chemotherapy is ideal for HGBL, NOS. However, prospective trials are needed to prove whether the treatment of HGBL, NOS can be tailored based on NCCN-IPI.
在世界卫生组织（WHO）2016年更新版中，高级别非霍奇金淋巴瘤的命名被重新定义为高级别B细胞淋巴瘤（HGBL）。然而，在HGBL各实体中，未另行特别说明（NOS）的HGBL仍是一个描述欠佳的实体，关于其治疗和预后的文献较少。对未另行特别说明的HGBL病例的基线特征、治疗及结果进行了分析。2017年1月至2019年12月期间诊断出30例未另行特别说明的HGBL患者。他们的中位年龄为49.3岁，30%的患者国际预后指数（IPI）为晚期。大多数患者接受了R-CHOP化疗，而5例患者接受了剂量调整的R-EPOCH化疗。中位随访15个月时，9例患者出现疾病进展或复发。无事件生存期（EFS）和总生存期（OS）分别为22个月（12.1 - 31.9个月）和37个月（29.4 - 44.0个月）。只有NCCN-IPI≤2对结果有显著影响。结果与先前报道的结果相似。本研究强调了NCCN-IPI在确定未另行特别说明的HGBL预后中的重要性。文献综述表明，更强化的化疗对未另行特别说明的HGBL是理想的。然而，需要进行前瞻性试验来证明未另行特别说明的HGBL的治疗是否可以根据NCCN-IPI进行调整。
