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非霍奇金淋巴瘤的临床与治疗概况:来自奈季兰肿瘤中心的一项回顾性研究

Clinical and Therapeutic Profile of Non-Hodgkin's Lymphoma: A Retrospective Study From a Najran Oncology Center.

作者信息

Badheeb Ahmed M, Ahmed Faisal, Elhadi Musadag, Alyami Nasher, Badheeb Mohamed A

机构信息

Oncology, King Khalid Hospital-Oncology Center, Najran, SAU.

Urology, Ibb University, Ibb, YEM.

出版信息

Cureus. 2023 Jun 8;15(6):e40125. doi: 10.7759/cureus.40125. eCollection 2023 Jun.

Abstract

Background Non-Hodgkin lymphomas (NHL) represent a group of lymphoproliferative disorders, with a limited understanding of their clinical spectrum, primary extranodal variety, histopathology, and immunohistochemistry, particularly in developing countries. The objective of this study was to evaluate the clinicopathological characteristics and survival rates of NHL patients treated at King Khaled Hospital in Najran City, Saudi Arabia. Method In this retrospective chart review of NHL cases that received chemotherapy at the Oncology Center of King Khaled Hospital in Najran City, Saudi Arabia, between 2014 and 2021, we evaluated the clinicopathological features, survival rate, and associated factors. Using standardized data collection sheets, we extracted information on patients' age, gender, tumor type, stage, baseline laboratory evaluations, disease status, cancer treatment, and survival from electronic medical records. Univariate analysis was employed to identify factors associated with mortality and relapse. Results We included 43 NHL patients with a mean age of 59.23 ± 20.17 years, with a higher frequency among females (65.1%). B symptoms were present in 32 (74.4%) cases. The common primary site was peripheral lymph nodes (79.1%). Diffuse large B-cell lymphoma was the most common morphologic type (67.4%), and 46.5% of the patients had advanced-stage disease (stages III-IV). All patients received the first line of treatment, with the most common chemotherapy used being the RCHOP regimen (67.4%). Additionally, radiotherapy was performed in seven (16.3%) cases. Relapse occurred in eight (18.6%) cases with a median period of 47.5 months (Min: 20 - Max: 77 months). The mean overall survival time was 43.25 ± 2.98 months (range 12-168 months), and the one, three, and five-year survival rates were 91%, 58%, and 38%, respectively and the mortality rate was 32.6%. Univariate analysis showed that Burkitt lymphoma had (odds ratio (OR): 11.87; 95% confidence interval (CI): 1.58-89.09, p=0.016) and elevated lactate dehydrogenase (LDH) ((OR: 1.26; 95% CI: 0.35-4.54), p=0.014) were associated with mortality. Moreover, advanced age and the total number of first chemotherapy cycles were associated with relapse (p< 0.05). Conclusion The study highlights the variability of NHL cases, with a significant proportion presenting with advanced-stage disease and in middle age. The results suggest poor survival rates for patients with Burkitt lymphoma subtypes and elevated LDH levels.

摘要

背景

非霍奇金淋巴瘤(NHL)是一组淋巴增殖性疾病,人们对其临床谱、原发性结外类型、组织病理学和免疫组化的了解有限,尤其是在发展中国家。本研究的目的是评估在沙特阿拉伯纳季兰市哈立德国王医院接受治疗的NHL患者的临床病理特征和生存率。方法:在对2014年至2021年期间在沙特阿拉伯纳季兰市哈立德国王医院肿瘤中心接受化疗的NHL病例进行的回顾性病历审查中,我们评估了临床病理特征、生存率和相关因素。使用标准化的数据收集表,我们从电子病历中提取了患者的年龄、性别、肿瘤类型、分期、基线实验室评估、疾病状态、癌症治疗和生存情况等信息。采用单因素分析来确定与死亡率和复发相关的因素。结果:我们纳入了43例NHL患者,平均年龄为59.23±20.17岁,女性患者比例较高(65.1%)。32例(74.4%)出现B症状。常见的原发部位是外周淋巴结(79.1%)。弥漫性大B细胞淋巴瘤是最常见的形态学类型(67.4%),46.5%的患者患有晚期疾病(III-IV期)。所有患者均接受了一线治疗,最常用的化疗方案是RCHOP方案(67.4%)。此外,7例(16.3%)患者接受了放疗。8例(18.6%)患者出现复发,中位复发期为47.5个月(最小值:20 - 最大值:77个月)。平均总生存时间为43.25±2.98个月(范围12 - 168个月),1年、3年和5年生存率分别为91%、58%和38%,死亡率为32.6%。单因素分析显示,伯基特淋巴瘤(比值比(OR):11.87;95%置信区间(CI):1.58 - 八十九点零九,p = 0.016)和乳酸脱氢酶(LDH)升高((OR:1.26;95%CI:0.35 - 4.54),p = 0.014)与死亡率相关。此外,高龄和首次化疗周期总数与复发相关(p < 0.05)。结论:该研究突出了NHL病例的变异性,相当一部分患者为晚期疾病且处于中年。结果表明,伯基特淋巴瘤亚型和LDH水平升高的患者生存率较差。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fe04/10329418/2340dc286453/cureus-0015-00000040125-i01.jpg

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