Özlem YERSAL, Sevil KILÇIKSIZ, Bahriye PAYZIN, Burak Umut ÇAĞLAR, Tümay GÖKÇE, Süheyla DENİZ

Non-Hodgkin lenfomalı olgularda standart prognostik faktörlerin 50 ve 60 yaş üstü-altı için değerlendirilmesi ve pik yaşı

AMAÇ Güncel non-Hodgkin lenfoma (NHL) çalışmalarında tedavi kararını prognostik özellikler de belirlemektedir. Çalışmamızda prognostik faktörleri hasta topluluğumuzda değerlendirdik.GEREÇ VE YÖNTEM Ocak 2001-Nisan 2004 dönemine ait 225 NHL'lı hasta (131 erkek, 94 kadın; ort. yaş 51) geriye dönük olarak incelendi. Yaş, cinsiyet, histolojik tip, tutulum yeri, ‘bulky' hastalık ve ekstranodal tutulum varlığı; karaciğer, akciğer, dalak, kemik iliği tutulumu; B semptomu varlığı, ‘ECOG' performans skoru, evre ve “Uluslararası Prognostik İndeks” (UPI) değerlendirildi. Olgularımız 60 ve 50 yaşa göre gruplandırıldı. Prognostik özellikler karşılaştırıldı.BULGULAR Görülme piki %23.6 ile 61-70 yaşta; ardından %19.6 ile 51- 60 yaştaydı. UPI ve ECOG-PS, 50 yaşa; 60 yaşa göre gruplandığında; daha yaşlı gruplar aleyhine anlamlı farklıydı (UPI için sırasıyla p=0.000, p=0.001; ECOG için sırasıyla p=0.003, p=0.006). UPI skoru 0-1 olan grup ve UPI >2 olan gruplarda ortalama yaşlar sırasıyla 44.95±15.28 ve 52.14±16.09 idi (p=0.002, t-test). Cinsiyet, evre, ‘bulky' kitle, B semptomu varlığı, tutulum yeri, ekstranodal tutulum v.d. açısından anlamlı farklılık yoktu.SONUÇ Elli ve 60 yaş üstü gruplarda kötü prognostik özelliklerin benzerliği; NHL kötü prognostik sınırın 60'dan daha genç yaşlarda olabileceğini düşündürmektedir. Belirgin farklılığın UPI (hatta ECOG-PS'da) bulunması ülkemizin düşük sosyoekonomik durumuyla uyumlu görünmektedir. Non-Hodgkin lenfomada prognostik faktörlerin ve tedavi protokollarının ülkemize göre değerlendirilmesi gereklidir.

Evaluation of standart prognostic factors according to age cut-off values (60 years and 50 years) and peak age in our non-Hodgkin's lymphomas patients

OBJECTIVES Recently prognostic factors have gained importance in determining treatment decision in non-Hodgkin lymphomas (NHL). In this study PFs were examined in NHL patients.METHODS The records of 225 NHL patients (131 males; 94 females; mean age 51 years) applying to our hospital between January 2001 and April 2004 were evaluated retrospectively. Age, sex, histologic type, localization of disease, bulky tumor, extranodal involvement, involvement of liver, lung, spleen, bone marrow, presence of B symptoms, ECOG-PS, stage, IPI were investigated as PFs. Patients were divided into two groups according to two age cut-off values (60 years and 50 years). Thus subgroups were compared with respect to these PFs.RESULTS Peak ages were 61-70 (23. 6% of patients), and then 51-60 (19.6%). IPI and ECOG-PS were significantly worse for older subgroups in both age groups (IPI; p

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