PROGNOSIS FACTORS IN AGGRESSIVE NON-HODGKIN LYMPHOMAS WITH PRIMARY INVOLVEMENT OF THE SPLEEN

Objective: The increased morbidity and DALY rates in the working-age population, commonly late diagnosis and unfavorable socio-economic impact of non-Hodgkin lymphomas (NHL) can be considered as key issues of hemato-oncology. Clinico-hematological patterns of primary NHL of the spleen indicate the n...

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Autores principales:	Larisa Musteata, Ion Corcimaru, Vasile Musteata
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Diseases of the blood and blood-forming organs RC633-647.5
Acceso en línea:	https://doaj.org/article/9868fe7020f5499bb9931c2512380d30
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spelling	oai:doaj.org-article:9868fe7020f5499bb9931c2512380d302021-11-10T04:32:27ZPROGNOSIS FACTORS IN AGGRESSIVE NON-HODGKIN LYMPHOMAS WITH PRIMARY INVOLVEMENT OF THE SPLEEN2531-137910.1016/j.htct.2021.10.970https://doaj.org/article/9868fe7020f5499bb9931c2512380d302021-11-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2531137921011172https://doaj.org/toc/2531-1379Objective: The increased morbidity and DALY rates in the working-age population, commonly late diagnosis and unfavorable socio-economic impact of non-Hodgkin lymphomas (NHL) can be considered as key issues of hemato-oncology. Clinico-hematological patterns of primary NHL of the spleen indicate the need of searching the prognosis factors in order to optimize treatment tactics. The objective of the study was distinguishing of clinical and hematological prognosis factors in aggressive NHL of the spleen. Methodology: This analytical, cohort study enrolled 45 patients with primary high-grade (HG) NHL of the spleen, who were treated at the Institute of Oncology from Moldova. The diagnosis was proved by cytological, histopathological and immunohistochemical examinations. The types of NHL were assessed according to the Revised 2017 WHO Classification of Tumors of Hematopoietic and Lymphoid Tissues. The patients age ranged between 15-82 years (median - 51.9 years). Stage IV NHL was revealed in 38 (84.6%) cases. Results: In stage IV NHL with primary involvement of the spleen, the 5-year overall survival (OS) of patients under the age of 50 was 38.5%, above 50 years - 19.8%. The bone marrow (BM) involvement reduced the 5-year OS (24.1%). The average life-span was 23.5 months in cases without leukemic conversion (LC) and 7.4 months in those with LC. When treated with splenectomy and chemotherapy, the 5-year OS attained 47.2%. The 5-year OS accounted 14.0% in stage IV patients treated only with combined therapy. Conclusion: The post-splenectomy correction of cytopenias persuaded an increase of the OS (54.5%) in cases with refractory cytopenic syndrome. The stage IV, BM dissemination, leukemic conversion, patients age ≥ 50 years, the unfeasibility of performing splenectomy and the resistance of cytopenias to splenectomy may be suggested as the unfavorable prognostic factors in aggressive NHL with primary involvement of the spleen, which should be taken into account in order to optimize treatment options.Larisa MusteataIon CorcimaruVasile MusteataElsevierarticleDiseases of the blood and blood-forming organsRC633-647.5ENHematology, Transfusion and Cell Therapy, Vol 43, Iss , Pp S15-S16 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diseases of the blood and blood-forming organs RC633-647.5
spellingShingle	Diseases of the blood and blood-forming organs RC633-647.5 Larisa Musteata Ion Corcimaru Vasile Musteata PROGNOSIS FACTORS IN AGGRESSIVE NON-HODGKIN LYMPHOMAS WITH PRIMARY INVOLVEMENT OF THE SPLEEN
description	Objective: The increased morbidity and DALY rates in the working-age population, commonly late diagnosis and unfavorable socio-economic impact of non-Hodgkin lymphomas (NHL) can be considered as key issues of hemato-oncology. Clinico-hematological patterns of primary NHL of the spleen indicate the need of searching the prognosis factors in order to optimize treatment tactics. The objective of the study was distinguishing of clinical and hematological prognosis factors in aggressive NHL of the spleen. Methodology: This analytical, cohort study enrolled 45 patients with primary high-grade (HG) NHL of the spleen, who were treated at the Institute of Oncology from Moldova. The diagnosis was proved by cytological, histopathological and immunohistochemical examinations. The types of NHL were assessed according to the Revised 2017 WHO Classification of Tumors of Hematopoietic and Lymphoid Tissues. The patients age ranged between 15-82 years (median - 51.9 years). Stage IV NHL was revealed in 38 (84.6%) cases. Results: In stage IV NHL with primary involvement of the spleen, the 5-year overall survival (OS) of patients under the age of 50 was 38.5%, above 50 years - 19.8%. The bone marrow (BM) involvement reduced the 5-year OS (24.1%). The average life-span was 23.5 months in cases without leukemic conversion (LC) and 7.4 months in those with LC. When treated with splenectomy and chemotherapy, the 5-year OS attained 47.2%. The 5-year OS accounted 14.0% in stage IV patients treated only with combined therapy. Conclusion: The post-splenectomy correction of cytopenias persuaded an increase of the OS (54.5%) in cases with refractory cytopenic syndrome. The stage IV, BM dissemination, leukemic conversion, patients age ≥ 50 years, the unfeasibility of performing splenectomy and the resistance of cytopenias to splenectomy may be suggested as the unfavorable prognostic factors in aggressive NHL with primary involvement of the spleen, which should be taken into account in order to optimize treatment options.
format	article
author	Larisa Musteata Ion Corcimaru Vasile Musteata
author_facet	Larisa Musteata Ion Corcimaru Vasile Musteata
author_sort	Larisa Musteata
title	PROGNOSIS FACTORS IN AGGRESSIVE NON-HODGKIN LYMPHOMAS WITH PRIMARY INVOLVEMENT OF THE SPLEEN
title_short	PROGNOSIS FACTORS IN AGGRESSIVE NON-HODGKIN LYMPHOMAS WITH PRIMARY INVOLVEMENT OF THE SPLEEN
title_full	PROGNOSIS FACTORS IN AGGRESSIVE NON-HODGKIN LYMPHOMAS WITH PRIMARY INVOLVEMENT OF THE SPLEEN
title_fullStr	PROGNOSIS FACTORS IN AGGRESSIVE NON-HODGKIN LYMPHOMAS WITH PRIMARY INVOLVEMENT OF THE SPLEEN
title_full_unstemmed	PROGNOSIS FACTORS IN AGGRESSIVE NON-HODGKIN LYMPHOMAS WITH PRIMARY INVOLVEMENT OF THE SPLEEN
title_sort	prognosis factors in aggressive non-hodgkin lymphomas with primary involvement of the spleen
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/9868fe7020f5499bb9931c2512380d30
work_keys_str_mv	AT larisamusteata prognosisfactorsinaggressivenonhodgkinlymphomaswithprimaryinvolvementofthespleen AT ioncorcimaru prognosisfactorsinaggressivenonhodgkinlymphomaswithprimaryinvolvementofthespleen AT vasilemusteata prognosisfactorsinaggressivenonhodgkinlymphomaswithprimaryinvolvementofthespleen
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PROGNOSIS FACTORS IN AGGRESSIVE NON-HODGKIN LYMPHOMAS WITH PRIMARY INVOLVEMENT OF THE SPLEEN

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