scholarly journals Nonfollicular small B-cell lymphomas: a heterogeneous group of patients with distinct clinical features and outcome

Blood ◽  
1994 ◽  
Vol 83 (10) ◽  
pp. 2829-2835 ◽  
Author(s):  
F Berger ◽  
P Felman ◽  
A Sonet ◽  
G Salles ◽  
Y Bastion ◽  
...  
Keyword(s):  
Cell Lymphoma ◽  
Clinical Stage ◽  
Performance Status ◽  
Poor Performance ◽  
Large Cell ◽  
Lactic Dehydrogenase ◽  
Small Cell ◽  
Poor Performance Status ◽  
Advanced Clinical Stage ◽  
Histologic Subtype

Abstract Two hundred sixteen patients with a nonfollicular small cell lymphoma followed up in our department over a 5-year period have been reviewed to define the clinical behavior and survival of patients with each histologic subtype. The respective frequencies of major subtypes were: small lymphocytic/lymphoplasmacytoid lymphoma (immunocytoma, SL/LPL), 28%; large cell-rich immunocytoma (LCRI), 7%; mantle cell lymphoma (MCL), 24%; mucosa-associated lymphoid tissue-lymphoma (MALT-L), 20%; other rare subtypes, 6%; and nonclassified or nonreviewed, 14%. The SL/LPL patients and the MALT-L patients had a relatively indolent disease, usually disseminated for SL/LPL and usually localized for MALT- L. Both subtypes have a long time to treatment failure (TTF; median, 48 and 58 months, respectively) and long survival (median, 118 and 98 months, respectively). The LCRI patients or the MCL patients had more aggressive clinical or biologic features and experienced shorter TTF (median, 26 and 14 months, respectively) and shorter survival (median, 55 and 52 months, respectively). None of these histologic subtypes was associated with a significant cure rate. MALT-L patients did relapse regardless of the initial localization or treatment and at a similar rate to the SL/LPL patients. Factors associated with a worse outcome in nonfollicular small cell lymphoma patients are identical to those described in other lymphoma subtypes: advanced clinical stage, poor performance status, high tumor bulk, and high lactic dehydrogenase or beta 2microglobulin levels. For patients with disseminated disease, standard chemotherapy regimens did not allow a long TTF; therefore, new therapeutic strategies must be developed.

Patients with Mature T-Cell Lymphoma Show High Relapse Rates after High Dose Therapy and Autologous Stem Cell Transplantation

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 774-774 ◽  
Author(s):  
Maike Nickelsen ◽  
Carmen Canals ◽  
Norbert Schmitz ◽  
Charalampia Kyriakou ◽  
Monika Engelhardt ◽  
...  
Keyword(s):  
Relative Risk ◽  
T Cell ◽  
Cell Lymphoma ◽  
Performance Status ◽  
Poor Performance ◽  
Large Cell ◽  
T Cell Lymphoma ◽  
Poor Performance Status ◽  
High Dose ◽  
Refractory Disease

Abstract Patients (pts) with mature (peripheral) T-cell lymphoma are known to have a poor prognosis when receiving standard conventional chemotherapy. This leads many physicians to regard high dose chemotherapy (HDT) followed by autologous stem cell transplantation (ASCT) as standard therapy for these pts. We here present a retrospective analysis on 424 pts with mature T-cell lymphoma who have received HDT and ASCT in EBMT centres between 2000 and 2005. Patients with primary cutaneous or immature (lymphoblastic) lymphoma were not included. Histological subtypes were anaplastic large cell lymphoma (ALCL, n=98, 23.1%; 19 anaplastic large cell kinase (ALK) positive, 42 ALK negative and for 37 pts the ALK status was unknown), peripheral T-cell lymphoma (PTCLu, n=176, 41.5%), angioimmunoblastic T-cell lymphoma (n=120, 28.3%) and aggressive T-cell lymphoma unspecified (n=30, 7.1%). Median age at ASCT was 51 years (17.2–73.5), median time from diagnosis to ASCT was 9 months (4–99), and median follow up for surviving pts was 36 months (0.4–99). 268 pts (63%) were male. 1/3 received HDT and ASCT after only one previous treatment line. 35% of the pts were treated in CR1, and 52% in chemosensitive disease worse than CR1. At the time point of ASCT only 12 pts (2.8%) had a poor performance status. 9% of the pts received total body irradiation as part of the conditioning regimen. At 3 years after ASCT non relapse mortality (NRM) was 7.4% and the relapse rate (RR) was 43.1%. In multivariate COX analysis for NRM refractory disease (p<0.001, relative risk 6.7) and poor performance status at ASCT (p=0.02, relative risk 3.2) were statistically significant adverse factors while the RR was significantly influenced by histology (PTCLu versus other subgroups, p=0.02, relative risk 1.4), and disease status at ASCT (refractory disease versus CR1 p=0.001, relative risk 3.3 and chemosensitive disease versus CR1 p=0.001, relative risk 1.9). At 3 years progression free survival (PFS) was 49.5% and overall survival (OS) 62.3%. In multivariate COX analysis adjusted for PFS refractory disease and chemosensitive disease worse than CR1 were significant adverse factors compared to CR1 (p<0.001 each, relative risk 3.2 and 1.7, respectively) as was refractory disease compared to chemosensitive disease (including CR1; p=0.004, relative risk 1.9). Other significant adverse factors were age at SCT 60 years (p=0.04, relative risk 1.4), poor performance status at ASCT (p=0.046, relative risk 2.1) and PTCLu versus other subgroups (p=0.02, relative risk 1.4). In summary there was a high RR for this group of pts who actually received ASCT. Especially refractory pts and pts in poor performance status did not benefit from the procedure. Further studies are necessary to better define the pts who will actually be cured by ASCT and to early identify the pts who will need other approaches and thus can be spared high dose chemotherapy which may negatively influence later salvage regimen.

scholarly journals Feasibility and effectiveness of afatinib for poor performance status patients with EGFR-mutation-positive non-small-cell lung cancer: a retrospective cohort study

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chiao-En Wu ◽  
Ching-Fu Chang ◽  
Chen-Yang Huang ◽  
Cheng-Ta Yang ◽  
Chih-Hsi Scott Kuo ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Prognostic Factors ◽  
Small Cell Lung Cancer ◽  
Disease Control ◽  
Performance Status ◽  
Poor Performance ◽  
Small Cell ◽  
Poor Performance Status ◽  
Small Cell Lung ◽  
Nsclc Patients

Abstract Background Afatinib is one of the standard treatments for patients with epidermal growth factor receptor (EGFR)-mutated non-small-cell lung cancer (NSCLC). However, data on the use of afatinib in patients with poor performance status (PS ≥ 2) are limited. This study aimed to retrospectively review the clinical outcomes and safety of afatinib treatment in EGFR-mutation-positive (EGFRm+) NSCLC patients with PS ≥ 2. Methods The data for 62 patients who were treated at Linkou Chang Gung Memorial Hospital from January 2010 to August 2019 were retrospectively reviewed. Patients’ clinicopathological features were obtained, and univariate and multivariate analyses were performed to identify possible prognostic factors. Data on adverse events were collected to evaluate general tolerance for afatinib therapy. Results Until February 2020, the objective response rate, disease control rate, median progression-free survival (PFS), and overall survival (OS) were 58.1% (36/62), 69.4% (43/62), 8.8 months, and 12.9 months, respectively. The absence of liver metastasis (PFS: p = 0.044; OS: p = 0.061) and good disease control (p < 0.001 for PFS and OS) were independent favorable prognostic factors for PFS and OS. Bone metastasis (p = 0.036) and dose modification (reduction/interruption, p = 0.021) were predictors of disease control. Conclusion Afatinib demonstrated acceptable efficacy and safety in the current cohort. This study provided evidence to support the use of afatinib as a first-line treatment in EGFRm+ NSCLC patients with poor PS.

scholarly journals Poor Prognosis of Diffuse Large B-Cell Lymphoma with Hepatitis C Infection

2021 ◽  
Vol 11 (9) ◽  
pp. 844
Author(s):  
Yu-Fen Tsai ◽  
Yi-Chang Liu ◽  
Ching-I Yang ◽  
Tzer-Ming Chuang ◽  
Ya-Lun Ke ◽  
...  
Keyword(s):  
Hepatitis C ◽  
B Cell ◽  
Cell Lymphoma ◽  
Performance Status ◽  
Poor Performance ◽  
B Cell Lymphoma ◽  
Liver Involvement ◽  
Poor Performance Status ◽  
Large B Cell Lymphoma ◽  
Large B Cell

Background: Hepatitis C virus (HCV) in diffuse large B-cell lymphoma (DLBCL) is associated with a higher prevalence and distinctive clinical characteristics and outcomes. Methods: A retrospective analysis of adult DLBCL patients from 2011 to 2015 was studied. Results: A total of 206 adult DLBCL were enrolled with 22 (10.7%) HCV-positive patients. Compared to HCV-negative patients, the HCV-positive group had a poor performance status (p = 0.011), lower platelet count (p = 0.029), and higher spleen and liver involvement incidences (liver involvement, p = 0.027, spleen involvement, p = 0.026), and they received fewer cycles of chemotherapy significantly due to morbidity and mortality (p = 0.048). Overall survival was shorter in HCV-positive DLBCL (25.3 months in HCV-positive vs. not reached (NR), p = 0.049). With multivariate analysis, poor performance status (p < 0.001), advanced stage (p < 0.001), less chemotherapy cycles (p < 0.001), and the presence of liver toxicity (p = 0.001) contributed to poor OS in DLBCL. Among HCV-positive DLBCL, the severity of liver fibrosis was the main risk factor related to death. Conclusion: Inferior survival of HCV-positive DLBCL was observed and associated with poor performance status, higher numbers of complications, and intolerance of treatment, leading to fewer therapy. Therefore, anti-HCV therapy, such as direct-acting antiviral agents, might benefit these patients in the future.

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