Prognostic factors and survival in non-hodgkin's lymphomas: The experience of the istituto oncologico romagnolo (IOR)

Enzo Pasquini, Mario Nicolini, Giovanni Rosti, Marinella Amadori, Stefano Pileri, Oriana Nanni, Pier Paolo Fattori, Maurizio Marangolo, Dino Amadori, Alberto Ravaioli

Research output: Contribution to journalArticlepeer-review

Abstract

In an attempt to evaluate natural history, prognostic factors and survival, the data of 340 patients with NHL were collected. 267 patients were evaluable for the analysis of prognostic factors and survival. The tumor samples were reviewed and reclassified according to the Kiel classification. At completion, 180 patients were affected by low-grade (LG)-NHL and 87 patients had high-grade (HG)-NHL. Numerous potential prognostic factors were analysed in univariate and multivariate analyses. Globally 154 patients (57.4% obtained complete remission (CR) and 65 patients (24.3% partial remission (PR). The response rate was similar in LG and HG-NHL groups. 5-years survival was 52% for all patients (53% in LG-NHL and 44% in HG-NHL). Median survival was 62 months in LG-NHL and 38 months in HG-NHL (p = n.s.). At the univariate analysis overall survival (OS) in LG-NHL was favourably influenced by age 80 (p <0.02), early clinical stage (p <0.001), absence of systemic symptoms (p <0.001), low serum LDH (p <0.001) and achievement of CR (p <0.001), while in the HG-NHL only by age (p = 0.005) and achievement of CR (p <0.001). The multivariate analysis showed early clinical stage, low serum LDH, absence of systemic symptoms and achievement of CR as independent prognostic factors in LG-NHL and only achievement of CR in HG-NHL. The univariate analysis for disease free survival (DFS) showed age (p <0.001), clinical stage (p <0.001), systemic symptoms (p <0.001), serum LDH (p <0.001) and bulky disease (p = 0.03) as prognostic factors in LG-NHL and age (p = 0.006) in HG-NHL. At the multivariate analysis early clinical stage and low serum LDH appeared as independent prognostic factors in LG-NHL, whereas it was age in HG-NHL. Age and achievement of CR appear to be the most important prognostic factors for OS and DFS both in LG and HG-NHL and, in particular, the achievement of CR is extremely important in improving the prognosis regardless of the type of therapy adopted. In the near future the maximum effort should be made to ameliorate the quality of the treatments in an aim to attain the CR so as to have the opportunity to cure the largest possible number of patients with NHL.

Original languageEnglish
Pages (from-to)475-482
Number of pages8
JournalLeukemia and Lymphoma
Volume14
Issue number5-6
DOIs
Publication statusPublished - 1994

Keywords

  • Kiel classification
  • Non-Hodgkin's lymphomas
  • Prognostic factors
  • Survival

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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