Abdullah KATGI, Aybüke OLGUN, Selda KAHRAMAN, Özden PİŞKİN, Mehmet Ali ÖZCAN, Güner Hayri ÖZSAN, Fatih DEMİRKAN, Bülent ÜNDAR

Tek merkez deneyimi: Folliküler lenfomali olgularımızın retrospektif değerlendirmesi

Amaç: Folliküler lenfoma, ikinci en sık görülen lenfoma türü olup, bütün non hodgkin lenfomaların %20-25’ini, yavaş seyirli (indolen) lenfomaların ise %70’ini oluşturur. Ortalama yaşam beklentisi yaklaşık 10 yıldır. Fakat beklenen yaşam süresi monoklonal antikorların keşfi ile uzamıştır. Yöntemler: Bu çalışmada, folliküler lenfomalı 28 hastanın klinikopatolojik özellikleri, tedavi modaliteleri ve yanıt oranları retrospektif olarak değerlendirilmiştir. Bulgular: Hastaların %39,3’ünde B semptomları ve %35,7’sinde kemik iliği tutulumu mevcuttu. FLIPI skorlarına göre hastaların %37,5’i düşük, %21,4’ü orta ve %39,3’ü ise yüksek risk grubundaydı. Hastaların %32,1’i hastalığın erken evrelerinde idi. Hastaların %46,4’inde evre 1 ve %14,3’ünde evre 3 patolojik hastalık mevcuttu. %78,6 hasta kemoterapi almıştı ve en çok kullanılan rejim de CVP (%53,6) idi. %14,3 hastada radyoterapi uygulanmış ve hastaların %7,1’ i tedavisiz izlenmişti. 9 hastada rituksimab ilk sırada kullanılmış, 5 hastada ise ilk nükste kemoterapi ile birlikte uygulanmıştı. İlk sıra kemoterapi sonrası; toplam remisyon oranı %74 olmakla birlikte hastaların %46,4’ünde tam yanıt, %25’inde ise kısmi yanıt gözlendi. Ortanca izlem süresi 32,8 ay (5-101 ay) ve ortanca hastalıksız sağ kalım 22,5 aydı (1-67 ay). Sonuç: Çalışmamızın sonuçları doğrultusunda, folliküler lenfomada başlangıç tedavisinde rituksimablı kemoterapi rejimleri ve remisyon sağlanan olgularda idame rituksimab tedavisinin akılcı bir hasta yönetimi olduğunu düşünmekteyiz.

Anahtar Kelimeler:

İmmünoterapi, Lenfoma, folliküler, Geriyedönük çalışma

Single center experience: Retrospective analysis of folliculer lymphoma

Objectıve: Follicular lymphoma is the second most common lymphoma comprising 20–25% of all non hodgkin lymphomas and 70% of low grade lymphomas.Median survival is around 10 years but survival rates were improved since the discovery of monoclonal antibodies. Methods: In this study, the clinicopathological features, the treatment modalities and the response rates of 28 patients with follicular lymphoma were retrospectively analyzed. Results: 39.3% of patients had b symptoms and the bone marrow involvement rate was 35.7%. FLIPI scores; 35.7% of patients were in low risk group, 21.4% were in intermediate risk group and 39.3% were in high risk group. 32.1% of patiens were in early stages of disease. 46.4% of patients had grade 1 and 14.3% had grade 3 pathologic disease.78.6% of patients were treated with chemotherapy and the leading regimen was CVP (53.6%) 14.3% of patients were treated with radiotherapy and 7.1% of patients were followed without treatment.9 patients had rituximab as a firstline therapy and 5 patients had rituximab after first relapse with adjunct to the chemotherapy. 4 patients had rituximab as a maintanence therapy after remission. After firstline chemotherapy, with a total remission rate of 71.4,46.4% of patients had complete remission and 25% had partial remission.Median follow up time was 32.8 months (5–101 months) and median disease free survival was 22.5 months (1-67 months). Conclusion: We may conclude that the combination of rituximab with the firstline therapies and maintanence of rituximab after the first response is a rational way of management of follicular lymphoma with regard to the analysis of data obtained from this study.

Keywords:

Immunotherapy, Lymphoma, Follicular, Retrospective Studies,

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