Vol.14, No 3, 2007 pp. 117 - 120
UC 616.428.006.44
ANALYSIS OF PROGNOSTIC FACTORS IN HODGKIN'S
LYMPHOMA
WITH REGARD TO RESPONSE TO TREATMENT
Irena Ćojbašić, Lana Mačukanović-Golubović
Clinic of Haematology and Clinical Immunology, Clinical Center, Niš,
Serbia
E-mail: icojbasic@gmail.com
Summary. Hodgkin lymphoma (HL) is an uncommon malignancy involving
lymph nodes and lymphatic system. Due to the progress of the treatment,
HL becomes a potentially curable disease. International Prognostic Index
(IPI) was defined as the number of adverse prognostic factors presented
at diagnosis. This report aims to assess the predictive power of the IPI
for HL patients. On the basis of the retrospective study of patients with
HL, we analyzed the prognostic significance of several factors with regard
to response to treatment. We reviewed the medical records of 26 patients
with HL, who were diagnosed and treated in our Clinic between 2004 and
2008. The median age of patients was 40 years, out of which 61.7% were
males. Most patients had nodular sclerosis (57.7%) and mixed cellular (38.5%)
histology. Clinical stage at diagnosis (AAS) was: I - II 46.1%, III - IV
53.9%. Presentation of IPI score was: low 26.9%, low intermediate 30.8%,
high intermediate 34.6% and high 7.7%. B-symptoms were recorded in 64.5%
of patients. Most of the patients received standard multi-agent chemotherapy
with the well-established ABVD regime which provides the best balance of
effectiveness and minimization of toxicity. Complete remission (CR) was
achieved in 69% of patients after the first-line therapy. Significantly
associated with the decrease of probability of achieving CR was the increased
IPI score itself (p=0.02) and two of the five factors analyzed: extranodal
disease >1 site (p=0.003) and poor performance status >1 (p=0.04). The
International Prognostic Index shows good prognostic power in HL.
Key words: Hodgkin lymphoma,
IPI, prognosis, treatment
ANALIZA PROGNOSTIČKIH FAKTORA KOD HOČKINOVOG
LIMFOMA
U ZAVISNOSTI OD ODGOVORA NA TERAPIJU
Kratak sadržaj: Hočkinov limfom (HL) je neobičan malignitet koji
zahvata limfne žlezde i limfni sistem. Zbog napretka u lečenju, HL je
postao potencijalno izlečiva bolest. Internacionalni prognostički indeks
(IPI) definiše se kao broj nepovoljnih prognostičkih faktora koji se
prezentuju pri dijagnozi. Cilj ovoga rada je da proceni predskazujuću
moć IPI skora kod pacijenata sa HL. Na osnovu retrospektivne studije pacijenata
obolelih od HL, analizirana je prognostička signifikantnost više faktora
prema odgovoru na terapiju. Razmatrane su medicinske istorije 26
pacijenata koji su dijagnostikovani i lečeni na našoj Klinici u periodu
od 2004. do 2008. godine. Prosečna starost pacijenata bila je 40 godina
a 61,7% od njih bili su muškarci. Većina pacijenata je od histoloških
tipova imala nodularnu sklerozu (57,7%) ili mešovitu celularnost (38,5%).
Klinički stadijum pri dijagnozi (AAS) bio je: I-II 46,1%, III-IV 53,9%.
Prezentacija IPI skora je bila: nizak 26,9%, srednje nizak 30,8%, srednje
visok 34,6% i visok 7,7%. B simptomi su bili prisutni kod 64,5% pacijenata.
Većina pacijenata je dobijala standardnu polihemioterapiju po dobro utvrđenom
ABVD protokolu koji obezbeđuje najbolji balans efikasnosti i minimalne
toksičnosti. Kompletna remisija (KR) je bila postignuta u 69% pacijenata
posle prve terapijske linije. Opadajuća mogućnost postizanja KR je bila
signifikantno udružena sa višim IPI skorom (p=0,02) i sa dva od pet analiziranih
faktora: ekstranodalna bolest >1 mesta (p=0,003) i loš performans status
>1 (p=0,04). Internacionalni prognostički indeks pokazao je dobru prognostičku
moć kod HL.
Ključne reči: Hočkinov limfom,
IPI, prognoza, tretman
