Contributions
Abstract: PB1997
Type: Publication Only
Background
NLPHL accounts for 5% of HL cases and its biology is different from classical HL (cHL). It has an indolent course, propensity for multiple and late relapses and high grade lymphomas. For this reason prognostic parameters are very important for risk adapted treatment strategy.
Aims
The aim of this study is to determine the prognostic significance of neutrophil lymphocyte ratio (NLR) which is an important inflammation parameter beside the known prognostic parameters such as sex, age, stage IV disease, serum albümin, low hemoglobin, leukocytosis, and lymphocytopenia used in cHL.
Methods
75 cases were retrospectively evaluated. Female/male ratio was 20/55. Albumin level < 4g/dl, hemoglobin<12g/dl, high WBC >10.109/L and lymphocytopenia <1x109/L were evaluated as poor prognostic indicators. Eleven cases had been treated by radiation alone, 32 had been treated by chemotherapy, 27 cases had been treated by chemotherapy and radiotherapy, two cases had been treated rituximab and three cases were followed without therapy.
Results
Seventy three percent of the cases had early stage disease, B symptoms and bulky disease were seen in in 15 and 6 cases, respectively. Bone marrow involvement was detected in 6 cases. Leukocytosis was found in 14 cases, lymphocytopenia in 11 cases and NLR was >4 in 26 cases. According to the relapse status mean and median progression free survival (PFS) were longer in cases with early stage disease (p:0.101) and with bulky disease (p:0.119). Mean and median PFS were significantly shorter in cases who had B symptom, low serum albumin and hemoglobin, leukocytosis, lymphocytopenia and high NLR(>4) groups (p:0.034, p:0.0001, p:0.033, p:0.0001, p:0.014; respectively). Figure 1 shows PFS curve according to NLR groups. According to multiple Cox regression analyses, among age, hemoglobin, albumin, stage, B symptom and NLR, NLR (OR:3.3; 95%CI:1.2-8.9; p:0.017) and hemoglobin (OR:4.8; 95%CI:1.4-16.7; p:0.050) were found to be independent risk factors related with PFS.
Conclusion
Higher NLR (>4) was found to be an important prognostic factor in cases with NLPHL. In relapse setting, developing an alternative scoring system including B symptoms, bulky disease and NLR will be more informative in determination of risk groups and risk adapted treatments in cases with NLPHL.
Note: Ethical approval has been taken from Cukurova University
Session topic: 17. Hodgkin lymphoma – Clinical
Keyword(s): Hodgkin's Lymphoma, Outcome measurement, Prognostic factor, Survival prediction
Abstract: PB1997
Type: Publication Only
Background
NLPHL accounts for 5% of HL cases and its biology is different from classical HL (cHL). It has an indolent course, propensity for multiple and late relapses and high grade lymphomas. For this reason prognostic parameters are very important for risk adapted treatment strategy.
Aims
The aim of this study is to determine the prognostic significance of neutrophil lymphocyte ratio (NLR) which is an important inflammation parameter beside the known prognostic parameters such as sex, age, stage IV disease, serum albümin, low hemoglobin, leukocytosis, and lymphocytopenia used in cHL.
Methods
75 cases were retrospectively evaluated. Female/male ratio was 20/55. Albumin level < 4g/dl, hemoglobin<12g/dl, high WBC >10.109/L and lymphocytopenia <1x109/L were evaluated as poor prognostic indicators. Eleven cases had been treated by radiation alone, 32 had been treated by chemotherapy, 27 cases had been treated by chemotherapy and radiotherapy, two cases had been treated rituximab and three cases were followed without therapy.
Results
Seventy three percent of the cases had early stage disease, B symptoms and bulky disease were seen in in 15 and 6 cases, respectively. Bone marrow involvement was detected in 6 cases. Leukocytosis was found in 14 cases, lymphocytopenia in 11 cases and NLR was >4 in 26 cases. According to the relapse status mean and median progression free survival (PFS) were longer in cases with early stage disease (p:0.101) and with bulky disease (p:0.119). Mean and median PFS were significantly shorter in cases who had B symptom, low serum albumin and hemoglobin, leukocytosis, lymphocytopenia and high NLR(>4) groups (p:0.034, p:0.0001, p:0.033, p:0.0001, p:0.014; respectively). Figure 1 shows PFS curve according to NLR groups. According to multiple Cox regression analyses, among age, hemoglobin, albumin, stage, B symptom and NLR, NLR (OR:3.3; 95%CI:1.2-8.9; p:0.017) and hemoglobin (OR:4.8; 95%CI:1.4-16.7; p:0.050) were found to be independent risk factors related with PFS.
Conclusion
Higher NLR (>4) was found to be an important prognostic factor in cases with NLPHL. In relapse setting, developing an alternative scoring system including B symptoms, bulky disease and NLR will be more informative in determination of risk groups and risk adapted treatments in cases with NLPHL.
Note: Ethical approval has been taken from Cukurova University
Session topic: 17. Hodgkin lymphoma – Clinical
Keyword(s): Hodgkin's Lymphoma, Outcome measurement, Prognostic factor, Survival prediction