Oana STANCA, Anca Mariana CIOBAN, Anca Roxana LUPU, Cecilia GHIMICI, Irina TRIANTAFYLLIDIS, Andrei COLITA and Ileana Delia MUT

ABSTRACT

Background: The International Prognostic Factors Project on Advanced Hodgkin lymphoma (HL) developed a seven factor prognostic score consisting of gender, age, stage, serum albumin, hemoglobin, leukocytosis and lymphocytopenia for the newly diagnosed Hodgkin disease patients in advanced stages, who receive chemotherapy.

Objectives: The purpose of this study was to determine whether this prognostic score would also be useful for refractory Hodgkin lymphoma patients in monitoring response to treatment.

Material and method: In the period 2000-2012, we performed a study on a group of 91 patients to show that the prognostic factors identified by the International Prognostic Factors (IPF) score affect the event- free survival (EFS) and the overall survival (OS). Our study also intends to show that the results of these factors change with the treatment response in patients with HL included in the category of patients with refractory disease.

Results: B symptoms, onset lymph node, more than 3 areas involved, bulky disease, extranodal involvement, low serum albumin, erythrocytes sedimentation rate (ESR), C reactive protein (CRP), lactic dehydrogenase (LDH) and anemia were associated with poorer EFS and OS. Male gender, stage, histological type, age (>45 years) and leukocytosis were not associated with significantly poorer outcomes.

Conclusions: the prognostic score for advanced disease is also useful in predicting relapse in patients with HL and early detection of response in patients with refractory HL.

Keywords: Follicular lymphoma, diagnosis, prognosis

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Anca CIOBANU, Oana STANCA, Irina TRIANTAFYLLIDIS and Anca LUPU

ABSTRACT

Introduction: Non-Hodgkin lymphomas represent malignant tumors of lymphoid cells. These chronic lymphoproliferative disorders stand for malignancies with varied histological aspects, clinical features, evolution, prognosis and aggressiveness. Follicular lymphomas are the most frequent form of indolent lymphomas and they represent around 25% of all malignant lymphomas in adults.

Material and method: Between 2011 and 2012, we have retrospectively observed, analyzed and described a group of 24 patients diagnosed with follicular lymphomas in the Department of Hematology from Coltea Hospital. The admittance criteria were: age, gender, hemoglobin and LDH levels, number lymph nodes affected and the Ann Arbor lymphoma staging system. Also used as patient study parameters were the following immunohistochemical criteria: CD20, UCHL1, CD79a, expression of Bcl 2 and Bcl 6, CD10 and the proliferative index (Ki-67).

Results: Multiple studies have shown that prognosis depends far more on clinical and histology parameters, including age, the presence of extra-node diseases and the performance status. In our study, regarding the ratio between the two genders, the male patients were more numerous than the female patients. The impairment of the male patients is associated with an unfavorable prognosis. From the age perspective, most of the diagnosed patients were part of the age group over 60. The age exceeding 60 is considered a negative prognosis factor. The serum lactate dehydrogenase (LDH) level is also considered an unfavorable prognosis factor. In our study, stage III and IV were frequently and this represents a poor prognosis factor.

Conclusions: Although it was a small number of patients, the results obtained correspond to the results existing in literature

Keywords: Follicular lymphoma, diagnosis, prognosis

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