Ege Üniversitesi Hastanesi veri tabanında kayıtlı erişkin Hodgkin lenfoma olgularının epidemiyolojik ve genel sağ kalım özelliklerinin retrospektif olarak değerlendirilmesi
Öz
Amaç: Hodgkin lenfoma (HL) sıklığı ve mortalite oranları tüm dünyada değişkenlik göstermektedir. Bu
çalışmada, HL olgularının epidemiyolojik ve genel sağ kalım analizlerinin, global sonuçlarla
karşılaştırılarak değerlendirilmesi amaçlanmıştır.
Gereç ve Yöntem: Ege Üniversitesi Kanserle Savaş Araştırma ve Uygulama Merkezi veri tabanına
kayıtlı, 1992-2017 yıllarında HL tanısı alan 972 erişkin olgu retrospektif olarak değerlendirilmiş,
CANREG-4 ile kaydedilen veriler SPSS’e aktarılmıştır.
Bulgular: Olguların %59,9’u erkek olup, ortalama tanı yaşı 41,8 ve medyan tanı yaşı 39 idi. Olguların
%94,4’ü klasik Hodgkin lenfoma (KHL) tanısı aldı. Alt tiplerine baktığımızda %42,1 nodüler sklerozan
(NS)-KHL, %31,0 mikst sellüler (MS)-KHL, %5,2 lenfositten zengin (LZ)-KHL, %2,9 lenfositten fakir
(LF)-KHL olarak değerlendirildi. Erkeklerde kadınlara göre anlamlı yüksekti. Noduler lenfosit
predominant HL olgularının tamamı EBV negatif iken; KHL olgularının %52,7’si pozitifti (p<0,0001).
Ayrıca %59 lokalize, %16,4 bölgesel, %24,7 yaygın hastalık oluşturmaktaydı. Sağ kalım analizleri
bilinen 971 olgunun sağkalımı 1 yıllık %92, 5 yılllık %81, 10 yıllık %70, 15 yıllık %62, 25 yıllık %43 idi.
Kemik iliği lokalizasyonundan tanı alan olguların sağ kalımının kısa olduğu saptandı (p<0,0001).
Sonuç: HL, en sık görülen ikinci lenfoma tipi olup, erkeklerde kadınlara göre daha sık karşımıza
çıkmaktadır. NSKHL en sık görülen alt tip olmakla birlikte, gelişmiş ülkelere göre biraz daha az
görüldüğü, MSKHL ve LFKHL alt tiplerinin ise daha ön plana çıktığı dikkatimizi çekmektedir. Ayrıca
olgularımızda EBV görülme oranları, gelişmiş ülkelere kıyaslandığında fazla olup, Asya ve Latin
Amerika’ya göre daha düşüktür. Erkeklerde, kemik iliği tutulumu olanlarda ve yaygın hastalık
oluşturanlarda sağ kalım daha kısa bulunmuştur. Prognostik açıdan, cinsiyet ve hastalık evresi bizim
çalışmamızda da öne çıkan önemli parametreler arasında saptanmıştır.
Anahtar Kelimeler
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, 2017:423- 442.
- Glaser SL, Jarrett RF. The epidemiology of Hodgkin’s disease. Baillieres Clin Haematol 1996;9(3):401–16.
- Ansell SM. Hodgkin lymphoma: 2018 update on diagnosis, risk-stratification, and management. Am J Hematol 2018;93:704–15.
- Alexander FE, Jarrett RF, Lawrence D, et al. Risk factors for Hodgkin's disease by Epstein-Barr virus (EBV) status: prior infection by EBV and other agents. Br J Cancer 2000;82(5):1117–21.
- Siegel RL, Miller KD, Jemal A. Cancer statistics, 2018. CA Cancer J Clin 2018;68(1):7–30.
- Shanbhag S, Ambinder R. Hodgkin lymphoma: a review and update on recent progres. CA Cancer J Clin 2019;68(2):116–32.
- Jaffe ES, Arber DA, Campo E, Harris NL, Quintanilla FL, Orazi A. Hematopathology. 2nd ed. Philadelphia, PA: Elsevier Ltd; 2016:507-45.
- Gerber NK, Atoria CL, Elkin EB, Yahalom J. Characteristics and Outcomes of Patients With Nodular Lymphocyte- Predominant Hodgkin Lymphoma Versus Those With Classical Hodgkin Lymphoma: A Population-Based Analysis. Int J Radiat Oncol Biol Phys 2015;92(1):76–83.
- Shimabukuro-Vornhagen A, Haverkamp H, Engert A, et al. Lymphocyte-Rich Classical Hodgkin’s Lymphoma: Clinical Presentation and Treatment Outcome in 100 Patients Treated Within German Hodgkin’s Study Group Trials. J Clin Oncol 2005;23(24):5739–45.
- Gobbi PG, Ferreri AJM, Ponzoni M, Levis A. Hodgkin lymphoma. Crit Rev Oncol Hematol 2013;85(2):216–37.
- Bazzeh F, Rihani R, Howard S, Sultan I. Comparing adult and pediatric Hodgkin lymphoma in the Surveillance, Epidemiology and End Results Program, 1988 – 2005: an analysis of 21734 cases. Leuk Lymphoma 2010;51(12):2198-207.
- Pauw D. Nodular lymphocyte predominant Hodgkin lymphoma in USA between 2000 and 2014: an updated analysis based on the SEER data. Br J Haematol 2018;182:712–42.
- Memiş Y, Kandaz M, Serdar L, Canyilmaz E. Hodgkin lenfomalı hastaların klinik özellikleri ve tedavi sonuçlarının geriye dönük analizi: Tek merkez deneyimi. Turk Onkoloji Dergisi 2015;30(1):16–20.
- Belkaid MI, Zerhouni F, Beljord K, et al. Association of Epstein-Barr virus and Hodgkin’s disease: comparison between Algerian and French patients. Bull Cancer. 1995;82(5):357–63.
- Weiss LM, Chen Y, Liu X, Shibata D. Epstein-Barr Virus and Hodgkin’s Disease. A correlative in situ hybridization and polymerase chain reaction study. Am J Pathol 1991;139(6):1259–65.
- Zhou XG, Hamilton-Dutoit SJ, Yan QH, Pallesen G. The association between Epstein-Barr virus and Chinese Hodgkin’s disease. Int J Cancer. 1993;55(3):359–63.
- Park CS, Juhng SW, Brigati DJ, Montone KT. Analysis of Epstein-Barr virus in Hodgkin’s disease: Experience of a single university hospital in Korea. J Clin Lab Anal 1994;8(6):412–7.
- Chan JK, Yip TT, Tsang WY, Lau WH, Wong CS, Ma VW. Detection of Epstein-Barr virus in Hodgkin’s disease occurring in an oriental population. Hum Pathol 1995;26(3):314–8.
- Chang KL, Albújar PF, Chen YY, Johnson RM, Weiss LM. High prevalence of Epstein-Barr virus in the Reed-Sternberg cells of Hodgkin’s disease occurring in Peru. Blood 1993;81(2):496–501.
- Gulley ML, Eagan PA, Quintanilla-Martinez L, et al. Epstein-Barr virus DNA is abundant and monoclonal in the Reed- Sternberg cells of Hodgkin’s disease: association with mixed cellularity subtype and Hispanic American ethnicity. Blood 1994;83(6):1595–602.
- Quintanilla-Martínez L, Gamboa-Domínguez A, Gámez-Ledesma I, Orozco-Estevez H, Angeles-Angeles A. High prevalence of the Epstein-Barr virus in a Mexican population with Hodgkin’s disease. Rev Invest Clin 1994;46(5):355–62.
- Yang M, Ping L, Liu W, et al. Clinical characteristics and prognostic factors of primary extranodal classical Hodgkin lymphoma: a retrospective study. Hematology 2019;24(1);413-19.
- Ma J, Wang Y, Zhao H, et al. Clinical characteristics of 26 patients with primary extranodal Hodgkin lymphoma. Int J Clin Exp Pathol 2014;7(8):5045–50.
- Men Y, Sun X, Wei D, Yu Z. Primary extranodal head and neck classical Hodgkin lymphoma: A rare clinical case report. Exp Ther Med 2016;12(2):1007–11.
- Laurent C, Arber DA, Johnston P, Fend F, Zamo A, Attygalle AD. Diagnosis of classic Hodgkin lymphoma on bone marrow biopsy. Histopathology 2020;76(7):934-41.
- Connors JM. Hodgkin’s Lymphoma — The Great Teacher. N Engl J Med 2011;365(3):264-5.
Retrospective evaluation of the epidemiological and overall survival characteristics of adult Hodgkin lymphoma cases registered to Ege University Hospital database
Öz
Aim: Hodgkin lymphoma (HL) shows different incidence and mortality rates all over the world. The aim
of this study was to evaluate the epidemiological and overall survival analysis of HL patients and
compare them with global findings.
Materials and Methods: The data of HL, including 972 adult patients diagnosed within 1992-2017
and recorded at Ege University Cancer Control and Research Center by CANREG-4 program, were
evaluated retrospectively with SPSS.
Results: 59.9% of the patients were male; the mean age was 41.8, and the median age was 39. Of all
the patients, 94.4% were diagnosed as CHL. The subtypes of CHL were evaluated as 42.1% nodular
sclerosis (NS)-CHL, 31.0% mixed cellular (MC)-CHL, 5.2% lymphocyte-rich (LR)-CHL, 2.9%
lymphocyte-depleted (LD)-CHL. The disease was significantly predominant in males. While EBV was
negative in all nodular lymphocyte predominant Hodgkin lymphoma patients, 52.7% of CHL patients
were positive with EBV (p<0.0001). Also, 59% of the patients had localized, 16.4% regional, 24.7%
disseminated disease. Overall survival rates for 1, 5, 10, 15, 25-year were 92%, 81%, 70%, 62%, 43%
respectively. The patients those had been diagnosed with the bone marrow biopsy had been detected
to have poor prognosis (p<0.0001).
Conclusion: In our study, HL is the second most common lymphoma type; the incidence is more
common in males than females. Although among our patients NSCHL is the most common subtype of
CHL, it has a bit less percentage than developed countries, MCCHL and LDCHL subtypes are also
prominent in our country. Also, our EBV incidence is higher compared with developed countries but
lower than in Asia and Latin America. Overall survival is found lower in patients with male gender,
bone marrow involvement, and disseminated disease. Gender and stage of the disease were found to
be among the most important prognostic parameters in our study.
Anahtar Kelimeler
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, 2017:423- 442.
- Glaser SL, Jarrett RF. The epidemiology of Hodgkin’s disease. Baillieres Clin Haematol 1996;9(3):401–16.
- Ansell SM. Hodgkin lymphoma: 2018 update on diagnosis, risk-stratification, and management. Am J Hematol 2018;93:704–15.
- Alexander FE, Jarrett RF, Lawrence D, et al. Risk factors for Hodgkin's disease by Epstein-Barr virus (EBV) status: prior infection by EBV and other agents. Br J Cancer 2000;82(5):1117–21.
- Siegel RL, Miller KD, Jemal A. Cancer statistics, 2018. CA Cancer J Clin 2018;68(1):7–30.
- Shanbhag S, Ambinder R. Hodgkin lymphoma: a review and update on recent progres. CA Cancer J Clin 2019;68(2):116–32.
- Jaffe ES, Arber DA, Campo E, Harris NL, Quintanilla FL, Orazi A. Hematopathology. 2nd ed. Philadelphia, PA: Elsevier Ltd; 2016:507-45.
- Gerber NK, Atoria CL, Elkin EB, Yahalom J. Characteristics and Outcomes of Patients With Nodular Lymphocyte- Predominant Hodgkin Lymphoma Versus Those With Classical Hodgkin Lymphoma: A Population-Based Analysis. Int J Radiat Oncol Biol Phys 2015;92(1):76–83.
- Shimabukuro-Vornhagen A, Haverkamp H, Engert A, et al. Lymphocyte-Rich Classical Hodgkin’s Lymphoma: Clinical Presentation and Treatment Outcome in 100 Patients Treated Within German Hodgkin’s Study Group Trials. J Clin Oncol 2005;23(24):5739–45.
- Gobbi PG, Ferreri AJM, Ponzoni M, Levis A. Hodgkin lymphoma. Crit Rev Oncol Hematol 2013;85(2):216–37.
- Bazzeh F, Rihani R, Howard S, Sultan I. Comparing adult and pediatric Hodgkin lymphoma in the Surveillance, Epidemiology and End Results Program, 1988 – 2005: an analysis of 21734 cases. Leuk Lymphoma 2010;51(12):2198-207.
- Pauw D. Nodular lymphocyte predominant Hodgkin lymphoma in USA between 2000 and 2014: an updated analysis based on the SEER data. Br J Haematol 2018;182:712–42.
- Memiş Y, Kandaz M, Serdar L, Canyilmaz E. Hodgkin lenfomalı hastaların klinik özellikleri ve tedavi sonuçlarının geriye dönük analizi: Tek merkez deneyimi. Turk Onkoloji Dergisi 2015;30(1):16–20.
- Belkaid MI, Zerhouni F, Beljord K, et al. Association of Epstein-Barr virus and Hodgkin’s disease: comparison between Algerian and French patients. Bull Cancer. 1995;82(5):357–63.
- Weiss LM, Chen Y, Liu X, Shibata D. Epstein-Barr Virus and Hodgkin’s Disease. A correlative in situ hybridization and polymerase chain reaction study. Am J Pathol 1991;139(6):1259–65.
- Zhou XG, Hamilton-Dutoit SJ, Yan QH, Pallesen G. The association between Epstein-Barr virus and Chinese Hodgkin’s disease. Int J Cancer. 1993;55(3):359–63.
- Park CS, Juhng SW, Brigati DJ, Montone KT. Analysis of Epstein-Barr virus in Hodgkin’s disease: Experience of a single university hospital in Korea. J Clin Lab Anal 1994;8(6):412–7.
- Chan JK, Yip TT, Tsang WY, Lau WH, Wong CS, Ma VW. Detection of Epstein-Barr virus in Hodgkin’s disease occurring in an oriental population. Hum Pathol 1995;26(3):314–8.
- Chang KL, Albújar PF, Chen YY, Johnson RM, Weiss LM. High prevalence of Epstein-Barr virus in the Reed-Sternberg cells of Hodgkin’s disease occurring in Peru. Blood 1993;81(2):496–501.
- Gulley ML, Eagan PA, Quintanilla-Martinez L, et al. Epstein-Barr virus DNA is abundant and monoclonal in the Reed- Sternberg cells of Hodgkin’s disease: association with mixed cellularity subtype and Hispanic American ethnicity. Blood 1994;83(6):1595–602.
- Quintanilla-Martínez L, Gamboa-Domínguez A, Gámez-Ledesma I, Orozco-Estevez H, Angeles-Angeles A. High prevalence of the Epstein-Barr virus in a Mexican population with Hodgkin’s disease. Rev Invest Clin 1994;46(5):355–62.
- Yang M, Ping L, Liu W, et al. Clinical characteristics and prognostic factors of primary extranodal classical Hodgkin lymphoma: a retrospective study. Hematology 2019;24(1);413-19.
- Ma J, Wang Y, Zhao H, et al. Clinical characteristics of 26 patients with primary extranodal Hodgkin lymphoma. Int J Clin Exp Pathol 2014;7(8):5045–50.
- Men Y, Sun X, Wei D, Yu Z. Primary extranodal head and neck classical Hodgkin lymphoma: A rare clinical case report. Exp Ther Med 2016;12(2):1007–11.
- Laurent C, Arber DA, Johnston P, Fend F, Zamo A, Attygalle AD. Diagnosis of classic Hodgkin lymphoma on bone marrow biopsy. Histopathology 2020;76(7):934-41.
- Connors JM. Hodgkin’s Lymphoma — The Great Teacher. N Engl J Med 2011;365(3):264-5.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 26 Ekim 2020 |
| Gönderilme Tarihi | 28 Ağustos 2020 |
| Yayımlandığı Sayı | Yıl 2020Cilt: 59 Özel Sayı: 1 (Onkoloji) |
Kaynak Göster
