Atakan TEKİNALP, Sinan DEMİRCİOĞLU, Volkan KARAKUŞ, Burhan TURGUT, Özcan ÇENELİ

YAYGIN BÜYÜK B HÜCRELİ LENFOMA (YBBHL) TANILI OLGULARIN RETROSPEKTİF DEĞERLENDİRMESİ

Amaç: Yaygın Büyük B Hücreli Lenfoma (YBBHL), tüm lenfomaların yaklaşık %80’ini oluşturup en sık görülen non-Hodgkin lenfomadır. Prognostik açıdan heterojen karakterli olsa da monoklonal antikor rituksimabın tedaviye girmesiyle, sağ kalımda önemli iyileşme sağlanmıştır. Bu çalışmamızda YBBHL tanısı almış hastalarımızın 5 yıllık takip sürecinde yanıt, epidemiyolojik özellikler, progresyonsuz ve toplam sağ kalım analizlerini sunuyoruz. Materyal ve Metot: Çalışmamızda 3 merkezden YBBHL tanılı 160 olgunun demografik verileri, evre, risk grubu, ilk tedavi ve yanıtları, remisyon süreleri, relaps durumları ve görülen yan etkileri kaydedildi. İstatiksel analiz için Package for the Social Sciences (SPSS) 22.0 yazılımı kullanıldı. Sağ kalım değerlendirilmesi Kaplan-Meier analizi ile yapıldı. Sağ kalım üzerine anlamlılık ilişkisi long-rank testi ile saptandı, p değerinin 0.05'ten küçük olduğu analizler istatistiksel olarak anlamlı kabul edildi. Bulgular: Hastaların tanı anındaki yaş ortalaması 60,75 ± 13,95 bulundu. Yüzdokuz hastada (%68,1) sadece nodal tutulum, 51’inde (%31,9) ise ekstranodal tutulum gözlendi. Erkek hastalarda kadınlara göre ilk tedavi sonrası relaps oranı istatiksel anlamlı olarak yüksek bulundu. Evre ile genel sağ kalım (GSK) ve tedavi yanıt arasında bir fark saptanmazken (p=0,140 ve p=0,378), progresyonsuz sağ kalım (PSK) süreleri ile anlamlı fark elde edilmiştir (p=0,038). Ayrıca nodal ve ekstranodal tutulumlu hastaların GSK ve PSK süreleri arasında anlamlı fark saptanmamıştır. Risk değerlendirmesi açısından yaşa göre ayarlanmış uluslar arası prognostik indeks (age adjuested international prognostic index-aaIPI) risk grubu arttıkça, ilk tedaviye yanıt oranlarının azaldığı görülmüştür (p=0,031). Sonuç: Çalışmamızda YBBHL tanılı hastaların popülasyonundaki genel karakteristiği ortaya konulmuş olup risk faktörlerin ise literatür ile karşılaştırıldığında sonuçların benzer olduğu görülmüştür.

Aim: Diffuse Large B Cell Lymphoma (DLBCL) is the most common NHL and %80 of all NHLs. Although it has some subtypes with heterogenous characteristic for prognosis, in area of rituximab monoclonal anti-body, improvement in overall survival (OS) was achieved. We evaluated response of treatment, epidemiologic features, OS and progression-free survival (PFS) of our patients with DLBCL for 5-years retrospectively. Materials and Methods: We investigated 160 patients from three centers in Turkey. Demografic features, stages, risk groups, the type of first-line therapy and its reason, duration of remission, relapse status and adverse events were collected. Package for the Social Sciences (SPSS) 22.0 program were used for statistical analysis. Dates of survival and significancies were obtained by Kaplan-Meier analysis and long-rank test, respectively. Analyses with p values below 0.05 were recognized as statistically significant. Results: Mean age of patients at the time of diagnoses was 60.75 ± 13.95. Number of patients with only nodal involved and extranodal involved were 109 (%68,1) and 51 (%31,9), respectively. Frequency of relaps after the first therapy was significancy superior in males than females. Althought there was no significant differencies between stage and OS, and response to treatment (p=0,140 ve p=0,378), significant difference was obtained between stage and PFS (p=0,038). In additon there wasn’t significant differencies between OS and PFS among patients with nodal and extranodal involved. Otherwise patients with advance age adjuested international prognostic index (aaIPI) scores had significancy inferior rate of response of first treatment (p=0,031). Conclusion: We demosrated the characteristics of patients with DLBCL as a general population and other else results related risk factors were similary with literatures.

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