Clinical characteristics and prognosis of B-cell non-Hodgkin lymphoma with abnormal leukocyte count

doi:10.3969/j.issn.1006-7795.2018.03.004

Abstract

Abstract: Objective To raise our understanding of B-cell non-Hodgkin lymphoma (B-NHL) patients with an abnormal leukocyte count at diagnosis, by summarizing and analyzing the characteristics and prognosis.Methods Retrospective analysis was performed on B-NHL patients with an abnormal leukocyte count in the initial diagnosis who were seen during January, 2011 to December, 2017;the clinical features,routine laboratory tests,bone marrow examinations,early responses were summarized. Overall survival (OS) and progression-free survival (PFS) were assessed and analyzed for factors that may affect the clinical prognosis.Results The median age of 68 patients was 63 (19-80) years. Marginal zone B-cell lymphoma (MZL), diffuse large B-cell lymphoma (DLBCL) were the most common pathological subtypes. The Ann Arbor stage was in Ⅲ/IV stage or leukemic phase. Patients accompanied with anemia and/or thrombocytopenia accounted for 67.7%(46/68). The proportion of bone marrow involvement patients was 91.7% (55/60). Of 53 patients, 15 (28%) were accompanied with myelofibrosis; 40 patients were eligible for early response assessment,CR rate was 17.5%(7/40),and ORR was 55.0% (22/40). It was associated with the increased LDH, platelet count in the initial diagnosis and the improvement of bone marrow after the first treatment at early efficacy evaluation. Forty-three patients were followed up to January, 2018, the median follow-up time was 22 (1-70) months, the median PFS and OS were 13 (95% CI:2.721-23.279) months and 24 (95% CI:8.722-39.278) months, respectively. In a multivariate analysis, B-symptoms were the factors of OS, either CR or PR obtained through early treatment affected OS and PFS.Conclusion B-NHL with an abnormal leukocyte count had late phase,they often had B-symptoms and abnormal LDH. Bone marrow involvement was common in most patients,they were often found anemia and thrombocytopenia. A few patients achieved CR or PR after early treatment, they often had a short PFS. So further studies regarding long-term outcomes are required. Either CR or PR achieved through early treatment affected OS and PFS. Patients with leukemic phase could achieve better CR or PR if given ALL-intensive therapy,and more studies are needed.

Key words: B-cell non-Hodgkin lymphoma, leukocyte count, bone marrow involvement, progression-free survival, overall survival

CLC Number:

R557

Wang Kun, Zhang Jianhua, Zhang Ruijuan, Dong Chunxia, Ma Xiaowen, Shen Xing, Chen Kun, Chang Shuting, Yang Linhua. Clinical characteristics and prognosis of B-cell non-Hodgkin lymphoma with abnormal leukocyte count[J]. Journal of Capital Medical University, 2018, 39(3): 327-334.

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URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2018.03.004

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2018/V39/I3/327

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