Araştırma Makalesi
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Retrospective evaluation of the epidemiological and overall survival characteristics of adult non-Hodgkin lymphoma cases registered to Ege University Hospital database

Yıl 2020, Cilt: 59 Özel Sayı: 1 (Onkoloji), 66 - 78, 26.10.2020
https://doi.org/10.19161/etd.815316

Öz

Aim: Non-Hodgkin's lymphomas (NHL) are a heterogeneous group of lymphoproliferative diseases. The aim of this study was to evaluate the epidemiological analysis of NHL patients and compare them to global findings.

Materials and Methods: The data including 4.561 adult patients diagnosed as NHL, and recorded at Ege University Cancer Control and Research Center, within 1992-2017 were evaluated retrospectively.

Results: Of the patients, 56.7% was male; the mean age was 56.77, the median age was 59. The most common lymphoma type of NHL was 38.1% diffuse large B-cell lymphoma (DLBCL), followed by small lymphocytic lymphoma, marginal zone lymphoma, follicular lymphoma (FL). 52.5% of the patients had been diagnosed within nodal, 31% extranodal localization. While mature B-cell neoplasms increased in years, mature T-cell neoplasms did not increase in years. The non-specified type of NHL decreased in years. The disease was significantly higher in males than females in all age groups (p=0,003). About half of the patients were in the age range of 40-64.Except for mantle cell lymphoma, which was mostly detected in patients older than 64 years, all other types were mostly seen in the 40-64 age range 86.2% of Burkitt lymphoma patients, which is mostly diagnosed in pediatric age group, were in the 18-64 age range.

Conclusion: While FL is more common in Western Europe and North America, DLBCL is more common in the World. In our study, DLBCL is the most common NHL type, FL is less common compared to Western countries. NHL incidence is more common in males than females in our study. Also, the ratio of localized disease increase in years, and while the ratio of localized disease is more in the 18-39 age range, the disseminated disease is more detected in years of older age. In our study, we evaluated an extensive series of NHL patients diagnosed in 25 years’ period, and it provides an important epidemiological data for our region of the country.

Kaynakça

  • Swerdlow SH, Campo E, Harris NL, et al. WHO classification of tumours of haematopoietic and lymphoid tissues, 4th edition (IARC WHO Classification of Tumours, Volume 2). International agency for research on Cancer (IARC). Lyon, 2017:215-421.
  • Guerard EJ, Bishop MR. Overview of Non-Hodgkin’s Lymphoma. Dis Mon 2012;58(4):208–18.
  • Li Y, Wang Y, Wang Z, Yi D, Ma S. Racial Differences in Three Major NHL Subtypes: Descriptive Epidemiology. Cancer Epidemiol 2016;39(1):8–13.
  • Pulte D, Jansen L, Gondos A, et al. Survival of patients with non-Hodgkin lymphoma in Germany in the early 21st century. Leuk Lymphoma 2013;54(5):979-85.
  • Shankland KR, Armitage JO, Hancock BW, Park W. Non-Hodgkin lymphoma. Lancet 2012;380(9844):848–57.
  • Siegel R, Ward E, Brawley O, Jemal A. Cancer Statistics, 2011: The Impact of Eliminating Socioeconomic and Racial Disparities on Premature Cancer Deaths. CA Cancer J Clin 2011;61(4):212-36.
  • Skrabek P, Turner D, Seftel M. Epidemiology of Non-Hodgkin Lymphoma. Transfus Apher Sci 2013;49(2):133–8.
  • Bray F, Ferlay J, Soerjomataram I, Siegel R, Torre LA, Jemal A. Global Cancer Statistics 2018: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin 2018;68(6):394–424.
  • Morton LM, Wang SS, Devesa SS, Hartge P, Weisenburger DD, Linet M. Lymphoma incidence patterns by WHO subtype in the United States, 1992-2001. Blood. 2006;107(1):265–76.
  • Zell M, Assal A, Derman O, Kornblum N, et al. Adult T-cell leukemia/lymphoma in the Caribbean cohort is a distinct clinical entity with dismal response to conventional chemotherapy. Oncotarget 2016;7(32): 51981–90.
  • Czarnota J, Gennings C, Colt JS, et al. Analysis of Environmental Chemical Mixtures and Non-Hodgkin Lymphoma Risk in the NCI-SEER NHL Study. Environ Health Perspect 2015;123(10):965–70.
  • Witte HM, Hertel N, Merz H, et al. Clinicopathological characteristics and MYC status determine treatment outcome in plasmablastic lymphoma : a multi-center study of 76 consecutive patients. Blood Cancer J 2020;10(5):63.
  • Au WY, Gascoyne RD, Klasa RD, et al. Incidence and spectrum of non-Hodgkin lymphoma in Chinese migrants to British Columbia. Br J Haematol 2005;128(6):792–6.
  • Morgan G, Vornanen M, Puitinen J, et al. Changing trends in the incidence of non-Hodgkin’s lymphoma in Europe. Biomed Study Group. Ann Oncol 1997;8(Suppl 2):49–54.
  • Mounier M, Bossard N, Remontet L, et al. Changes in dynamics of excess mortality rates and net survival after diagnosis of follicular lymphoma or diffuse large B-cell lymphoma: comparison between European population-based data (EUROCARE-5). Lancet Haematol 2015;2(11):e481-91.
  • Crozier JA, Sher T, Yang D, et al. Persistent Disparities Among Patients With T-Cell Non-Hodgkin Lymphomas and B-Cell Diffuse Large Cell Lymphomas Over 40 Years: A SEER Database Review. Clin Lymphoma, Myeloma Leuk 2015;15(10):578–85

Ege Üniversitesi Hastanesi veri tabanında kayıtlı erişkin Hodgkin dışı lenfoma olgularının epidemiyolojik özelliklerinin retrospektif olarak değerlendirilmesi

Yıl 2020, Cilt: 59 Özel Sayı: 1 (Onkoloji), 66 - 78, 26.10.2020
https://doi.org/10.19161/etd.815316

Öz

Amaç: Hodgkin dışı lenfomalar (NHL), lenfoproliferatif hastalıkların da yer aldığı heterojen bir gruptur. Bu çalışmada, NHL olgularının epidemiyolojik analizlerinin yapılması, global sonuçlarla karşılaştırılarak değerlendirilmesi amaçlanmıştır.

Gereç ve Yöntem: Ege Üniversitesi Kanserle Savaş Araştırma ve Uygulama Merkezi veri tabanına kayıtlı, 1992-2017 yıllarında NHL tanısı alan 4.561 erişkin olgu retrospektif olarak değerlendirilmiştir.

Bulgular: Olguların %56,7’si erkek olup; ortalama yaş 56,77, ortanca yaş 59 idi. En sık %38,1 diffüz büyük B-hücreli lenfoma (DBBHL) olmak üzere sırasıyla küçük lenfositik lenfoma, marjinal zon lenfoma, folliküler lenfoma (FL) izlendi. Olguların %52,5’i nodal, %31’i ekstranodal yerleşimden tanı aldı. Matür B-hücreli neoplazmlar yıllara göre artış gösterirken, matür T-hücreli neoplazmlarda artış saptanmadı. Sınıflandırılamayan NHL olgularının ise yıllara göre azaldığı dikkatimizi çekti. Tüm yaş gruplarında erkeklerde kadınlara göre daha fazla idi (p=0,003). Olguların yaklaşık yarısı 40-64 yaş aralığındaydı. Ayrıca mantle hücreli lenfoma (MHL) hariç, diğer histolojik tiplerin en çok 40-64 yaş aralığında; MHL’nın ise en çok 65 yaş ve üstü grupta karşımıza çıktığı izlendi. Çocukluk yaş grubunda sık görülen Burkitt lenfomada ise olguların %86,2’si 18-64 yaş aralığında idi.


Sonuç: FL, Batı Avrupa ve Kuzey Amerika’da daha sık görülürken, DBBHL Dünya’da daha yaygın görülmektedir. Bizim çalışmamızda da DBBHL en sık görülen NHL tipidir. FL ise Batı toplumları ile kıyaslandığında daha az karşımıza çıkmaktadır. Çalışmamızda NHL’ler erkeklerde kadınlara göre daha sıktır. Ayrıca yıllara göre hastalığın lokalize kalma eğiliminin arttığı ve yaş gruplarına göre de 18-39 yaş aralığında daha lokalize kalma eğiliminde iken, yaş arttıkça daha yaygın hastalık tablosu oluşturduğu dikkatimizi çekmiştir. NHL’ye ait 25 yılı kapsayan çok geniş bir serinin değerlendirildiği çalışmamız, ülkemize ait epidemiyolojik verilerin belirlenebilmesi açısından önem taşımaktadır.

Kaynakça

  • Swerdlow SH, Campo E, Harris NL, et al. WHO classification of tumours of haematopoietic and lymphoid tissues, 4th edition (IARC WHO Classification of Tumours, Volume 2). International agency for research on Cancer (IARC). Lyon, 2017:215-421.
  • Guerard EJ, Bishop MR. Overview of Non-Hodgkin’s Lymphoma. Dis Mon 2012;58(4):208–18.
  • Li Y, Wang Y, Wang Z, Yi D, Ma S. Racial Differences in Three Major NHL Subtypes: Descriptive Epidemiology. Cancer Epidemiol 2016;39(1):8–13.
  • Pulte D, Jansen L, Gondos A, et al. Survival of patients with non-Hodgkin lymphoma in Germany in the early 21st century. Leuk Lymphoma 2013;54(5):979-85.
  • Shankland KR, Armitage JO, Hancock BW, Park W. Non-Hodgkin lymphoma. Lancet 2012;380(9844):848–57.
  • Siegel R, Ward E, Brawley O, Jemal A. Cancer Statistics, 2011: The Impact of Eliminating Socioeconomic and Racial Disparities on Premature Cancer Deaths. CA Cancer J Clin 2011;61(4):212-36.
  • Skrabek P, Turner D, Seftel M. Epidemiology of Non-Hodgkin Lymphoma. Transfus Apher Sci 2013;49(2):133–8.
  • Bray F, Ferlay J, Soerjomataram I, Siegel R, Torre LA, Jemal A. Global Cancer Statistics 2018: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin 2018;68(6):394–424.
  • Morton LM, Wang SS, Devesa SS, Hartge P, Weisenburger DD, Linet M. Lymphoma incidence patterns by WHO subtype in the United States, 1992-2001. Blood. 2006;107(1):265–76.
  • Zell M, Assal A, Derman O, Kornblum N, et al. Adult T-cell leukemia/lymphoma in the Caribbean cohort is a distinct clinical entity with dismal response to conventional chemotherapy. Oncotarget 2016;7(32): 51981–90.
  • Czarnota J, Gennings C, Colt JS, et al. Analysis of Environmental Chemical Mixtures and Non-Hodgkin Lymphoma Risk in the NCI-SEER NHL Study. Environ Health Perspect 2015;123(10):965–70.
  • Witte HM, Hertel N, Merz H, et al. Clinicopathological characteristics and MYC status determine treatment outcome in plasmablastic lymphoma : a multi-center study of 76 consecutive patients. Blood Cancer J 2020;10(5):63.
  • Au WY, Gascoyne RD, Klasa RD, et al. Incidence and spectrum of non-Hodgkin lymphoma in Chinese migrants to British Columbia. Br J Haematol 2005;128(6):792–6.
  • Morgan G, Vornanen M, Puitinen J, et al. Changing trends in the incidence of non-Hodgkin’s lymphoma in Europe. Biomed Study Group. Ann Oncol 1997;8(Suppl 2):49–54.
  • Mounier M, Bossard N, Remontet L, et al. Changes in dynamics of excess mortality rates and net survival after diagnosis of follicular lymphoma or diffuse large B-cell lymphoma: comparison between European population-based data (EUROCARE-5). Lancet Haematol 2015;2(11):e481-91.
  • Crozier JA, Sher T, Yang D, et al. Persistent Disparities Among Patients With T-Cell Non-Hodgkin Lymphomas and B-Cell Diffuse Large Cell Lymphomas Over 40 Years: A SEER Database Review. Clin Lymphoma, Myeloma Leuk 2015;15(10):578–85
Toplam 16 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma Makaleleri
Yazarlar

Derya Demir 0000-0002-6333-8856

Nazan Özsan 0000-0001-7844-972X

Emre Demir 0000-0001-7552-8967

Ayşenur Arslan 0000-0002-5717-8331

Eren Arslan Davulcu 0000-0001-9262-2883

Nur Akad Soyer 0000-0002-7722-506X

Başak Doğanavşargil 0000-0002-4738-4350

Güray Saydam 0000-0001-8646-1673

Mahmut Töbü 0000-0001-5939-4989

Mine Hekimgil 0000-0002-9454-4521

Yayımlanma Tarihi 26 Ekim 2020
Gönderilme Tarihi 28 Ağustos 2020
Yayımlandığı Sayı Yıl 2020Cilt: 59 Özel Sayı: 1 (Onkoloji)

Kaynak Göster

Vancouver Demir D, Özsan N, Demir E, Arslan A, Davulcu EA, Akad Soyer N, Doğanavşargil B, Saydam G, Töbü M, Hekimgil M. Ege Üniversitesi Hastanesi veri tabanında kayıtlı erişkin Hodgkin dışı lenfoma olgularının epidemiyolojik özelliklerinin retrospektif olarak değerlendirilmesi. ETD. 2020:66-78.

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