TORNA ALL’ELENCO

Primary refractory disease in non-Hodgkin's lymphoma: A retrospective study on 3,952 newly diagnosed patients undergoing first-line chemotherapy in Blood

2012
AO Ordine Mauriziano

Tipo pubblicazione

Conference Abstract

Autori/Collaboratori (11)Vedi tutti...

Tarella C

Gueli A

Delaini F


et alii...

Abstract

Introduction: Non-Hodgkin's lymphoma (NHL) are malignant tumors usually sensitive to chemotherapy; this results in prolonged survival and possibly disease eradication in a large proportion of patients. However, despite the general improvement in treatment options, a variable number of patients still shows a refractory disease, i.e. poor or absent response to induction therapy. Prediction and management of refractory disease is a major issue in the biological and clinical research programs for NHL. The present study was undertaken to evaluate on a large series of NHL patients, managed at two Italian centers over the last three decades: i. the actual rate of refractory patients; ii. the main factors associated with refractory disease; iii. the long-term outcome of refractory vs. responsive patients. Patients and Methods: Data have been collected on a series of 3,952 NHL patients, referred and treated at the University Hematology of Torino (S. Giovanni B. and Mauriziano Hospitals) (864 cases) and at the Hematology Division of Ospedali Riuniti di Bergamo (3,088 cases), between 1984 and 2012. There were 1,819 (46%) female patients, 2,056 (52%) were aged less than 60 yrs, B-cell NHL were 3,633 (92%), with 318 (8%) patients diagnosed as T-NHL; main histological subtypes included: 1,809 (45.8%) Diffuse Large Cell Lymphoma (DLCL), 758 (19.2%) follicular lymphoma (FL), 210 (5.3%) mantle-cell lymphoma, the remaining 1,175 (29.7) had other histologies. According to Ann Arbor staging, 2,369 (62%) patients presented with advanced stage disease and 914 out of 2,174 evaluable patients (42%) had an intermediate-high IPI score. Overall, 1,430 out of 3,187 (44.9%) received conventional chemo-radiotherapy supplemented with rituximab. The criteria to identify refractory patients were: stable or progressive disease (fully refractory) or transient response with disease progression within 6 months (early relapse), following first-line chemotherapy. Results: Among 2,543 broadly analy

Keywords

rituximab; human; chemotherapy; society; hematology; patient; retrospective study; nonhodgkin lymphoma; survival; B lymphocyte; risk; relapse; female; therapy; T lymphocyte; disease course; histology; gender; large cell lymphoma; disease control; radiotherapy; staging; mantle cell lymphoma; hospital; malignant neoplasm; university; overall survival; follicular lymphoma; clinical research; follow up; treatment response; regression analysis; male; predictive value; prediction; life expectancy;