Journal of B.U.ON. : official journal of the Balkan Union of Oncology · 2014
Pretreatment risk factors for overall survival in patients with gastrointestinal and non-gastrointestinal mucosa associated lymphoid tissue lymphomas.
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Virijevic Marijana, Perunicic-Jovanovic Maja, Djunic Irena, Novkovic Aleksandra, Mihaljevic Biljana
Аннотация
PURPOSE: The aim of this 10-year retrospective study was to investigate prognostic clinical and laboratory factors significant for the outcome of patients with mucosa associated lymphoid tissue (MALT) lymphoma.
METHODS: The study involved 87 patients diagnosed with MALT lymphoma: 37 (42.5%) with gastrointestinal (GI) and 50 (57.5%) with non-GI localization. The following pretreatment laboratory parameters were analyzed: hemoglobin, serum albumin and lactate dehydrogenase (LDH) level, beta2-microglobulin (bgr;2-M) and bacteriological (H.pylori) status. Estimated clinical features were: stage of disease, ECOG performance status (PS), tumor mass, number of extranodal localizations, presence of B symptomatology, splenomegaly and enlarged lymph nodes. Diagnosis of MALT lymphoma was based on histopathological analysis of tissue samples, obtained by endoscopy or surgery.
RESULTS: The median disease-free survival (DFS) was 36 months and the 5-year overall survival (OS) was 64%. OS rate of patients with non-GI localization was higher compared with patients with GI localization (p=0.001). Multivariate analysis showed hypoalbuminemia to be the most significant parameter associated with poor OS (p<0.001) for both patient groups. The most significant prognostic factor for poor OS in patients with GI localization was LDH level (p=0.031), while hypoalbuminemia was the most significant prognostic factor for poor OS in the group with non-GI disease localization (p=0.001).
CONCLUSION: Proper therapeutic approach for MALT lymphoma patients could be planned taking into consideration poor prognostic parameters, i.e. hypoalbuminemia and elevated LDH for GI patients and hypoalbuminemia for non- GI lymphoma patients.
METHODS: The study involved 87 patients diagnosed with MALT lymphoma: 37 (42.5%) with gastrointestinal (GI) and 50 (57.5%) with non-GI localization. The following pretreatment laboratory parameters were analyzed: hemoglobin, serum albumin and lactate dehydrogenase (LDH) level, beta2-microglobulin (bgr;2-M) and bacteriological (H.pylori) status. Estimated clinical features were: stage of disease, ECOG performance status (PS), tumor mass, number of extranodal localizations, presence of B symptomatology, splenomegaly and enlarged lymph nodes. Diagnosis of MALT lymphoma was based on histopathological analysis of tissue samples, obtained by endoscopy or surgery.
RESULTS: The median disease-free survival (DFS) was 36 months and the 5-year overall survival (OS) was 64%. OS rate of patients with non-GI localization was higher compared with patients with GI localization (p=0.001). Multivariate analysis showed hypoalbuminemia to be the most significant parameter associated with poor OS (p<0.001) for both patient groups. The most significant prognostic factor for poor OS in patients with GI localization was LDH level (p=0.031), while hypoalbuminemia was the most significant prognostic factor for poor OS in the group with non-GI disease localization (p=0.001).
CONCLUSION: Proper therapeutic approach for MALT lymphoma patients could be planned taking into consideration poor prognostic parameters, i.e. hypoalbuminemia and elevated LDH for GI patients and hypoalbuminemia for non- GI lymphoma patients.