Breast Non Hodgkin’s Lymphoma (NHL): A Large Monocentric Study of Initial Characteristics, Natural History, and Prognostic Factors.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 2455-2455
Author(s):  
Philippe Arnaud ◽  
Bernard Asselain ◽  
Patricia Validire ◽  
Youlia Kirova ◽  
Corine Plancher ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Natural History ◽  
Univariate Analysis ◽  
Bone Marrow Involvement ◽  
Stage Iv ◽  
Complete Analysis ◽  
High Grade ◽  
Cns Involvement ◽  
Breast Radiotherapy ◽  
Historical Series

Abstract Breast NHL represents less than 1% of all lymphomas and 2% of lymphomatous extranodal sites. We therefore reviewed all patients treated at the Institut Curie between 1986 and 2004 for a NHL having initial breast localization to define their initial characteristics, natural history and prognostic factors. Forty-six cases were selected for the study. Pathological review according to the WHO classification showed 2 patients with lymphocytic lymphoma, 3 cases of grade I follicular NHL, 1 case of MALT lymphoma, 1 case of grade III follicular NHL, 1 Burkitt’s lymphoma, and 38 diffuse large cell lymphomas [namely, 40 cases (87%) of high-grade NHL]. A complete analysis was performed on the 40 high-grade NHL patients. Initial characteristics were: median age 62 years (range: 22–86), B symptoms 17%, PS < 2 in 92%, stages III-IV 57%, nodal involvement 57% (47% axillary sites), 2 or more extra-nodal sites 32% (15% of bone marrow involvement and 2.5% of central nervous system (CNS) involvement), elevated LDH in 37%, and IPI score of 0–1/2/3/4–5 in 45%/12%/12% and 15%, respectively. Treatment consisted of chemotherapy in all cases (chlorambucil 3, anthracycline-based regimen with (30) or without (7) intrathecal prophylaxis), breast radiotherapy in 29 cases (72%), and rituximab in 4 patients. At the end of initial therapy, 36 patients (90%) achieved CR. With a median follow-up of 96 months (range: 14–188), nineteen patients (47%) relapsed. Relapses were localized in 8 cases and diffuse in 11 cases; breast localizations were observed in 10 cases (53%), one of which included contralateral involvement, axillary in 5 cases, and CNS site involvement in 3 cases. Among relapsed patients, 8 cases achieved second CR (47 %). Among the 10 patients with breast relapses, 8 received localized radiotherapy during first-line therapy. The 2- and 5-year disease-free survivals (DFS) were 65% (95% CI: 51 to 81%) and 54 % (95% CI: 40 to 72%), respectively; the 2- and 5-year overall survivals (OS) were 74% (95% CI: 62 to 89%) and 61% (95% CI: 47 to 78%), respectively. In univariate analysis, stage IV, 2 or more extranodal sites, elevated LDH level, high IPI score, and CNS involvement were prognostic for lower DFS; moreover, age greater than 60 years, PS > 1, ESR > 30, IPI score > 2, and 2 or more extranodal sites influence adversely OS. In multivariate analysis, the presence of 2 or more extranodal sites (p = 0.0008; RR 5.48; 95% CI: 2.01–14.9) was the only one factor that had a pejorative impact on DFS (Figure 1.A). PS > 1 (p = 0.02; RR 3.63; 95% CI: 1.18–11.07) and 2 or more extranodal sites (p = 0.05; RR 2.64; 95% CI: 1.0–6.96) were associated with poor OS (Figure 1.B). Finally, high-grade selected patients were compared to a historical series of 111 patients with aggressive lymphomas treated at the Institut Curie between 1982 and 1997 with an anthracycline-based regimen. Ann Arbor stage adjusted OS was significantly lower for patients with initial breast involvement (p < 0.0383). In conclusion, initial breast localization has a pejorative impact on the outcome of NHL patients, with an impressive adverse influence of additional extranodal sites on both DFS and OS. These results suggest a specific management of NHL with breast involvement in prospective clinical trials.

Orbital Non Hodgkin’s Lymphoma (NHL): A Large Monocentric Study of Initial Characteristics, Natural History and Prognostic Factors.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 1378-1378
Author(s):  
Meunier Jerome ◽  
Lumbroso Livia ◽  
Dendale Remy ◽  
Vincent-Salomon Anne ◽  
Asselain Bernard ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Natural History ◽  
Cell Lymphoma ◽  
Malignant Tumors ◽  
Univariate Analysis ◽  
Bone Marrow Involvement ◽  
B Cell Lymphoma ◽  
Low Grade ◽  
High Grade

Abstract Orbital NHL (ocular and/or adnexal involvement) represents less than 1% of all lymphomas but about half of malignant tumors of the eye and/or ocular adnexae. We therefore reviewed all patients treated at the Institut Curie between 1970 and 2003 for a NHL exhibiting initial orbital localization to define their initial characteristics, natural history and prognostic factors. Among 172 patients, 145 cases with completed datas were selected for the study. Pathological review according to the WHO classification showed 52 cases of MALT-type lymphoma (36%), 32 lymphoplasmocytic lymphomas (22%), 14 patients with lymphocytic lymphoma, 7 cases of follicular lymphoma, 13 unspecified low grade lymphomas [namely, 118 cases (82%) of low grade NHL], 22 patients with diffuse large B-cell lymphoma (15%), 2 cases of mantle cell lymphoma, 2 Burkitt’s lymphomas and one T-lymphoblastic lymphoma [namely, 27 cases (18%) of high-grade NHL]. Initial characteristics were: median age 66 years (range 3–96), sex ratio M/F 0.6, B symptoms 6%, PS≥2 in 4% of patients, stages III–IV 31.7%, bone marrow involvement 12%, elevated LDH in 18% and IPI 0-1/2/3/4-5 in 92/28/13 and 1 cases, respectively. Anatomic localizations were intra-orbital in 39 patients (27%), conjunctival in 38 (26%), eyelid in 9 cases, lachrymal in 8 and other in 8 cases. Treatment of selected patients consisted of abstention in 2 cases, surgical complete resection in 5 cases, mono or polychemotherapy alone (CT) in 4 cases, and radiotherapy alone in 98 cases (68%) or with CT in 36 cases (25%). With a median follow-up of 90 months (range 3–314), the 5-year relapse-free (RFS) and overall (OS) survivals were 64% and 79% for the low-grade NHL, and 43% and 50% for the high-grade NHL. Prognostic factors were determined for the 118 low-grade patients. In univariate analysis, age greater than 59 years, elevated IPI score and elevated LDH level were prognostic for lower RFS and OS. In multivariate analysis, age greater than 59 years was the only prognostic factor for both lower RFS and OS (Figure 1). In conclusion, with a median follow-up of 7.5 years, our large monocentric cohort of patients represents one of the most important series that defines the initial characteristics, natural history and prognostic factors of NHL with initial orbital localization. Figure Figure

scholarly journals Prognostic factors in non-Hodgkin lymphomas

2000 ◽  
Vol 118 (1) ◽  
pp. 7-12 ◽  
Author(s):  
Karin Zattar Cecyn ◽  
José Salvador Rodrigues de Oliveira ◽  
Antônio Correia Alves ◽  
Maria Regina Regis Silva ◽  
José Kerbauy
Keyword(s):  
Prognostic Factors ◽  
Hodgkin Lymphoma ◽  
Low Grade ◽  
High Grade ◽  
Cns Involvement ◽  
Intermediate Grade ◽  
Non Hodgkin Lymphoma ◽  
Tumor Dissemination ◽  
Mediastinal Disease ◽  
Extranodal Disease

CONTEXT: In Hodgkin's disease, each clinical or pathologic stage can be related to the extent of the area involved and predicts the next anatomical region at risk for tumor dissemination. OBJECTIVE: To determine the best prognostic factors that could predict survival in non-Hodgkin lymphoma cases. DESIGN: A retrospective study. LOCATION: Department of Hematology and Transfusion Medicine, Universidade Federal de São Paulo - Escola Paulista de Medicina. PARTICIPANTS: 142 patients with non-Hodgkin lymphoma diagnosed between February 1988 and March 1993. MAIN MEASUREMENTS: Histological subset, Sex, Age, Race, B symptoms, Performance status, Stage, Extranodal disease, Bulk disease, Mediastinal disease, CNS involvement, BM infiltration, Level of DHL, Immunophenotype. RESULTS: In the first study (113 patients), the following variables had a worse influence on survival: yellow race (P<0.1); ECOG II, III e IV (P<0.1) and extranodal disease (P<0.1) for high grade lymphomas; constitutional symptoms (P<0.1), ECOG II, III e IV (P<0.1) and involvement of CNS (P<0.1) for intermediate grade and the subtype lymphoplasmocytoid (P=0.0186) for low grade lymphomas. In the second survey (93 patients), when treatment was included, the variables related to NHL survival were: CNS involvement (P<0.1) for high grade lymphomas, constitutional symptoms (P<0.1), ECOG II, III, IV (P=0.0185) and also CNS involvement (P<0.1) for the intermediate group. There were no variables related to the survival for low-grade lymphomas. CONCLUSIONS: The intermediate grade lymphomas were more compatible with data found in the literature, probably because of the larger number of patients. In this specific case, the treatment did not have an influence on the survival.

Mediastinal Mass with Bone Marrow Involvement Is a Favorable Factor for Childhood T-Lymphoid Malignancy in Japan.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 4525-4525
Author(s):  
Megumi Oda ◽  
Keiko Yumura-Yagi ◽  
Junichi Hara ◽  
Shinichiro Nishimura ◽  
Akio Tawa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bone Marrow ◽  
Prognostic Factors ◽  
T Cell ◽  
Mediastinal Mass ◽  
Bone Marrow Involvement ◽  
Stage Iv ◽  
Stage Iii ◽  
Lymphoid Malignancy ◽  
Specific Protocol

Abstract T-cell acute lymphoblastic leukemia (T-ALL) and T-cell lymphoblastic lymphoma (T-LBL) account for most of the childhood T-lymphoid malignancy(LM). T-ALL is usually treated by the same protocol to the B-progenitor ALL. It is obvious that biologically, T-cell behaviors are different from those of B-progenitor cell, and cell origins are same among T-ALL and T-LBL. Thus we conducted a strategy initiating T-ALL specific protocol, differing from protocols for B-progenitor ALL. Furthermore, we indicated the same protocol to advanced T-LBL. The aims of this study were to evaluate the efficacy and safety of indicating the same protocol for childhood T-ALL and advanced T-LBL, and to reveal the prognostic factors of childhood T-LM. 70 eligibleT-ALL patients enrolled in the JACLS ALL-97 study between 1997-2001, and 32 eligible patients with stage III and IV T-LBL enrolled in the JACLS NHL-T98 trial between 1998-2002 were analyzed. Median age was 9y8m (2y~15y3m) for T-ALL and 11y11m (3y~15y4m) for T-LBL. Male/female ratio was 46/24, 26/6, respectively. Mediastinal mass was found in 31/70(44.3%) for T-ALL, 19/21(90.5%) for stageIII and 6/11(54.5%) for stageIV T-LBL. The treatment for 2 years consisted of the induction therapy (VCR, HD-MTX, CA, PSL, ASP), the 5-drug consolidation therapy A and B, both including high dose of ASP, and maintenance therapy with block-rotated treatment using drugs above. Complete remission(CR) at the end of induction therapy was obtained 65/70(92.9%) for T-ALL, 15/21(71.4%) for stage III and 10/11(90.9%) for stage IV T-NHL. 5-year overall survival(OAS) rate for T-ALL, stage III and stage IV T-LBL was 81.1%, 63.9% and 81.8%, respectively. 5-year event free survival (EFS) rate was 72.9%, 47.6% and 72.3%, respectively. Relapse after CR occurred in 12/65 with T-ALL, 6/15 with stage III and 1/10 with stage IV T-LBL. Single variant analysis revealed that there were no significant difference in OAS or EFS for T-ALL patients based on WBC, NCI index, but statistical difference in OAS or EFS based on age(older than 10y worse), the existence of mediastinal mass(absence, worse) In T-LBL, there were no statistical differences based on age, existence of mediastinal mass. Multivariate analysis revealed, for T-ALL and T-LBL patients as a whole, that age > 10 years was a risk factor in both OAS and EFS, absence of mediastinal mass and stage III T-LBL were risk factors in OAS. Our data shows that indicating same T-cell specific protocol, for T-ALL and advanced T-LBL has a potential to improve the prognosis of T-LM. The older age, and stage III T-LBL appeared as prognostic factors. Moreover, mediastinal mass with bone marrow involvement was a favorable factor for childhood T-LM. Although some risk factors were documented, it is needed to clarify unknown prognostic factors and develop the more effective, stratified T-cell specific protocols.

Population characteristics and prognostic factors in metastatic non-small cell lung cancer (NSCLC): The Fox Chase Cancer Center (FCCC) experience

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 7644-7644
Author(s):  
V. Paralkar ◽  
T. Li ◽  
C. J. Langer
Keyword(s):  
Prognostic Factors ◽  
Serum Albumin ◽  
Performance Status ◽  
Univariate Analysis ◽  
Survival Rates ◽  
Stage Iv ◽  
Cranial Irradiation ◽  
Population Characteristics ◽  
Cancer Center ◽  
The Brain

7644 Background: With increasing use of MRI and PET to stage NSCLC, the demographics, performance status and distribution of metastases at diagnosis in this patient (pt) population are changing; it is important to reassess the prognostic roles played by baseline clinical variables in the modern therapeutic era. Methods: We retrospectively evaluated the charts of 189 consecutive, unselected pts with stage IV NSCLC seen and followed at the Fox Chase Cancer Center between Oct 2000 and Aug 2003. Data on a variety of pt variables including demographics, histology, metastases, key laboratory tests and treatment were compiled. We intended to identify those that played statistically significant prognostic roles. Results: Median age at diagnosis was 62 years; 77% of pts had PS 0–1 at first presentation. 58% had single organ metastasis; 35% had metastases to the brain (half of these had brain only and a third had solitary brain metastasis). 51% of all pts received palliative radiation to the brain at some point after dx. Overall median survival was 10.8 months. The 1-yr, 2-yr, 3-yr and 4-yr overall survival rates were 44.2%, 21.9%, 11.6% and 7.8% respectively. On multivariate analysis, statistically significant negative prognostic factors included PS ≥ 2 (HR: 1.9, 95% CI: 1.1–3.3), serum albumin ≤ 3 (HR: 1.7, 95% CI: 1.1–2.8) and metastases to > 1 organ (HR: 1.6, 95% CI: 1.03–2.3). Bone and liver metastases, though associated with worse survival in univariate analysis, were not found to be independent predictors of survival. Gender had no bearing on outcome. Conclusions: Survival rates in this advanced NSCLC cohort equal or exceed contemporaneous ECOG figures. PS, serum albumin and number of organs with metastases are independent prognostic factors in NSCLC. The increasing detection of brain metastases at 1st presentation of metastatic NSCLC suggests that the role of prophylactic cranial irradiation in the management of early NSCLC should be explored. No significant financial relationships to disclose. [Table: see text]

scholarly journals European Intergroup Studies (MMT4-89 and MMT4-91) on Childhood Metastatic Rhabdomyosarcoma: Final Results and Analysis of Prognostic Factors

2004 ◽  
Vol 22 (23) ◽  
pp. 4787-4794 ◽  
Author(s):  
M. Carli ◽  
R. Colombatti ◽  
O. Oberlin ◽  
G. Bisogno ◽  
J. Treuner ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Prognostic Factors ◽  
Complete Remission ◽  
Univariate Analysis ◽  
Bone Marrow Involvement ◽  
Local Therapy ◽  
High Dose Chemotherapy ◽  
High Dose ◽  
Multiple Metastases ◽  
Multiagent Chemotherapy

Purpose Final results are presented from two consecutive European studies for patients with metastatic rhabdomyosarcoma (RMS) to identify prognostic variables and determine the value of high-dose chemotherapy (HDCT) in complete remission. Patients and Methods A total of 174 patients aged 3 months to 18 years participated. From 1989 to 1991, patients received four cycles of intensive multiagent chemotherapy. From 1991 to 1995, patients achieving complete remission received consolidation with HDCT. All received local therapy (surgery, radiation therapy) according to response. Results At a median follow-up of 8 years, 5-year overall survival (OS) and event-free survival (EFS) for the whole group were 24% and 20%, respectively. No statistical difference was found between HDCT and standard chemotherapy (5-year OS, 36% v 27%; EFS 29% v 23%). Univariate analysis identified primary tumor in parameningeal, extremity, or other sites; age younger than 1 year and older than 10 years; bone or bone marrow metastases; multiple metastases; and multiple sites of metastases as unfavorable prognostic factors for OS and EFS. Multivariate analysis identified unfavorable site, bone or bone marrow involvement, and unfavorable age as independently unfavorable factors. Two subgroups were identified. Those with fewer than two unfavorable factors had 5-year EFS and OS of 40% and 47%, respectively. Patients with ≥ two unfavorable factors had 5-year EFS and OS of 7.5% and 9%, respectively. Conclusion A minority of patients with metastatic RMS have better survival than overall results for this population suggest. Those in the highest risk group have such poor survival that they are candidates for first-line novel therapies. There is no evidence that consolidation with HDCT improves outcome.

scholarly journals Small lymphocytic lymphoma: a clinicopathologic analysis of 268 cases

Blood ◽  
1989 ◽  
Vol 73 (2) ◽  
pp. 579-587
Author(s):  
J Ben-Ezra ◽  
JS Burke ◽  
WG Swartz ◽  
MD Brownell ◽  
RK Brynes ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Treatment Response ◽  
Univariate Analysis ◽  
Bone Marrow Involvement ◽  
Eastern Cooperative Oncology Group ◽  
Large Cell ◽  
Oncology Group ◽  
Small Lymphocytic Lymphoma ◽  
Symptom Type

We analyzed specimens from 268 patients with small lymphocytic lymphoma (SL) to identify prognostic factors significant for survival. These patients were staged and treated according to the protocols of the Cancer and Leukemia Group B, Eastern Cooperative Oncology Group, Southeastern Cancer Study Group, and the Southwest Oncology Group. Univariate analysis showed that a large-cell grade greater than I, WBC greater than 10,000/microL, hemoglobin (Hgb) less than 11 g/dL, age greater than or equal to 55 years, and failure to respond to treatment were all poor prognostic factors. Multivariate analysis showed that large-cell grade, age, degree of capsular invasion, and symptom type were independently associated with survival. Separate analyses of cases with and without leukocytosis indicated differences in survival. In patients without leukocytosis, age, presence or absence of anemia, and treatment response were significant prognostic variables; in patients with leukocytosis, large-cell grade, presence or absence of anemia, symptom type, and treatment response were significantly related to survival. Multivariate analysis showed that age was the only significant independent prognostic variable in patients without leukocytosis; in patients with leukocytosis, symptom type, large-cell grade, and bone marrow involvement were independently associated with survival. We conclude that several parameters, both clinical and pathologic, should be assessed at the initial diagnosis of SL to predict prognosis better.

scholarly journals Impact of Superselective Intra-Arterial and Systemic Chemoradiotherapy for Gingival Carcinoma; Analysis of Treatment Outcomes and Prognostic Factors

2020 ◽  
Author(s):  
Yuki Mukai ◽  
Yuichiro Hayashi ◽  
Izumi Koike ◽  
Toshiyuki Koizumi ◽  
Madoka Sugiura ◽  
...  
Keyword(s):  
Overall Survival ◽  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Clinical Stage ◽  
Performance Status ◽  
Univariate Analysis ◽  
Stage Iv ◽  
Progression Free Survival ◽  
Free Survival

Abstract Background: We compared outcomes and toxicity between radiation therapy (RT) with concurrent retrograde super-selective intra-arterial chemotherapy (IACRT) and RT with concurrent systemic chemoradiotherapy (SCRT), for gingival carcinoma (GC).　Methods: We included 84 consecutive patients who were treated for GC ≥ stage III, from 2006 to 2018, in this retrospective analysis (IACRT group: n=66; SCRT group: n=18).Results: Median follow-up time was 24 (range: 1–124) months. The median prescribed dose was 60 (6–70.2) Gy (IACRT group: 60 Gy; SCRT group:69 Gy). At 3 years, the two groups significantly differed in overall survival (OS; IACRT: 78.75%, 95% confidence interval [CI]: 66.00–87.62; SCRT: 50.37%, 95% CI: 27.58–73.0; P = 0.039), progression-free survival (PFS; IACRT: 75.64%, 95% CI: 62.69–85.17; SCRT: 41.96%, 95% CI: 17.65–70.90; P = 0.028) and local control (LC; IACRT: 77.17%, 95% CI: 64.23–86.41; SCRT: 41.96%, 95% CI: 17.65–70.90; P = 0.015). In univariate analysis, age ≥ 65, decreased performance status (PS) and SCRT were significantly associated with worse outcomes (P < 0.05). In multivariate analysis, age ≥ 65 years, clinical stage IV, and SCRT were significantly correlated with poor OS (P < 0.05). Patients with poorer PS had significantly worse PFS.Conclusions: This is the first report to compare outcomes from IACRT and SCRT among patients with GC. IACRT is an effective and organ-preserving treatment for GC.Trial registration: retrospectively registered

scholarly journals Small lymphocytic lymphoma: a clinicopathologic analysis of 268 cases

Blood ◽  
1989 ◽  
Vol 73 (2) ◽  
pp. 579-587 ◽  
Author(s):  
J Ben-Ezra ◽  
JS Burke ◽  
WG Swartz ◽  
MD Brownell ◽  
RK Brynes ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Prognostic Factors ◽  
Treatment Response ◽  
Univariate Analysis ◽  
Bone Marrow Involvement ◽  
Eastern Cooperative Oncology Group ◽  
Large Cell ◽  
Oncology Group ◽  
Small Lymphocytic Lymphoma ◽  
Symptom Type

Abstract We analyzed specimens from 268 patients with small lymphocytic lymphoma (SL) to identify prognostic factors significant for survival. These patients were staged and treated according to the protocols of the Cancer and Leukemia Group B, Eastern Cooperative Oncology Group, Southeastern Cancer Study Group, and the Southwest Oncology Group. Univariate analysis showed that a large-cell grade greater than I, WBC greater than 10,000/microL, hemoglobin (Hgb) less than 11 g/dL, age greater than or equal to 55 years, and failure to respond to treatment were all poor prognostic factors. Multivariate analysis showed that large-cell grade, age, degree of capsular invasion, and symptom type were independently associated with survival. Separate analyses of cases with and without leukocytosis indicated differences in survival. In patients without leukocytosis, age, presence or absence of anemia, and treatment response were significant prognostic variables; in patients with leukocytosis, large-cell grade, presence or absence of anemia, symptom type, and treatment response were significantly related to survival. Multivariate analysis showed that age was the only significant independent prognostic variable in patients without leukocytosis; in patients with leukocytosis, symptom type, large-cell grade, and bone marrow involvement were independently associated with survival. We conclude that several parameters, both clinical and pathologic, should be assessed at the initial diagnosis of SL to predict prognosis better.

Bone Marrow Histopathology and Prognosis in Malignant Lymphomas

1992 ◽  
Vol 78 (3) ◽  
pp. 176-180
Author(s):  
Roberto Navone ◽  
Achille Pich ◽  
Mauro Fiammotto ◽  
Corrado Magnani
Keyword(s):  
Bone Marrow ◽  
Univariate Analysis ◽  
Bone Marrow Involvement ◽  
Survival Rates ◽  
Low Grade ◽  
High Grade ◽  
Malignant Lymphomas ◽  
Cell Hyperplasia ◽  
Bone Marrow Histopathology ◽  
Lymphoid Nodules

Bone marrow trephine biopsies of patients with non-Hodgkin's malignant lymphomas (ML), followed for at least 4 years, were investigated using univariate and mutivariate survival analyses to detect which anagraphic data and histomorphologic medullary patterns before therapy were related to the prognosis. In 234 ML (146 low grade, 88 high grade), univariate analysis showed that survival was reduced by bone marrow involvement, absence of reactive lymphoid nodules, and low marrow cellularity. Moreover, in low-grade ML, patients 50 years or older and showing absence of myeloid hyperplasia, excess of hemosiderin and mast cell hyperplasia had significantly lower-survival rates. The prognostic relevance of these parameters did not change when cases without marrow involvement were separately analyzed. Multivariate analysis showed that, besides marrow involvement, age and myeloid hyperplasia had significant prognostic importance in low-grade ML, and lymphoid nodules in high-grade ML. Our data confirm the value of bone marrow histopathology in ML and indicate that the prognosis is related not only to medullary involvement but also to the morphology of the uninvolved marrow.

scholarly journals Splenic marginal zone lymphoma: clinical characteristics and prognostic factors in a series of 60 patients

Blood ◽  
2002 ◽  
Vol 100 (5) ◽  
pp. 1648-1654 ◽  
Author(s):  
Jose I. Chacón ◽  
Manuela Mollejo ◽  
Enriqueta Muñoz ◽  
Patricia Algara ◽  
Marisol Mateo ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Marginal Zone ◽  
Performance Status ◽  
Univariate Analysis ◽  
Bone Marrow Involvement ◽  
Eastern Cooperative Oncology Group ◽  
Marginal Zone Lymphoma ◽  
Response To Therapy ◽  
Splenic Marginal Zone Lymphoma ◽  
P53 Overexpression

A precise description of clinical features at presentation and analysis of clinical and biologic prognostic factors in splenic marginal zone lymphoma (SMZL) are still lacking. Here we describe the clinical and biologic features of a series of 60 SMZL patients diagnosed after splenectomy. Analysis for overall survival (OS), failure-free survival (FFS), and the probability of obtaining a response was performed using univariate and multivariate tests. The median age of the patient was 63 years (range, 35-84 years). Performance status according to the Eastern Cooperative Oncology Group (ECOG scale) was 0 = 16%, 1 = 58%, and 2 = 25%. Of the 60 patients, 53 (86.6%) were at Ann Arbor stage IV. All 60 patients received splenectomies, 29 of 60 also received chemotherapy, and 2 received spleen radiotherapy. A complete response (CR) was achieved by 38.3% of patients, and a partial response (PR) was achieved by 55%. Mean OS of the series was 103 months (range, 2-164 months); mean FFS was 40 months (range, 3-164 months). At 5 years from diagnosis, 39 patients (65%) were alive. Patients dying from the disease had a relatively aggressive clinical course, with a short survival (17.5 months [range, 2-72 months]). Significant prognostic factors in multivariate analysis were (1) (for OS and FFS) lack of response to therapy (CR versus noncomplete response [nCR]) and involvement of nonhematopoietic sites, and (2) (for the probability of obtaining CR) bone marrow involvement. Chemotherapy did not influence OS or FFS. p53 overexpression predicted a shorter OS in the univariate analysis. These data confirm the relative indolence of this disease, indicating the existence of a subset of more aggressive cases, which should stimulate the search for predictive biologic factors and alternative therapies.

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