Outcome of Non-Hodgkin’s Lymphoma in Adults-Real World Experience from a Cancer Centre in North-East India
摘要
Non-Hodgkin’s lymphoma (NHL) represent diverse subtypes categorized as per immunohistochemical, genetic, molecular and clinical diagnosis delineated by 2016 World Health Organization classification. Given limited real-world data on NHL in North-East India, the objective was to investigate the response and outcome in this cohort.
Materials and methodsDemographic, clinical, treatment and response characteristics of 214 NHL patients following frontline immunochemotherapy treated between December 2017 and January 2023 were retrospectively reviewed and analyzed to determine overall survival (OS) and event-free survival (EFS).
ResultsB cell-NHL accounted for 187 cases, followed by 27 T-NHL. Diffuse large B cell lymphoma (DLBCL) and peripheral T cell lymphoma, not otherwise specified, were the commonest B-NHL and T-NHL, respectively. Bulky disease was seen in 26(12.1%), advanced-stage in 137(64.01%), extra-nodal presentation in 77(35.98%),and grade 2 chemotherapy-related toxicity in 116(54.2%).The overall response rate was 73.36%, with complete response at 63.2% and progression at 20%. Median follow-up was 23 months (interquartile range 15–35 months). The 2-year EFS among those with complete/partial response was 77.7% compared to 24.53% among stable/progression. The 5-year OS was 47.84%. Those with good /low risk international prognostic index (IPI) had a 5-year OS of 62.09% compared to 25.17% among high/poor risk IPI. Most events, n = 72 out of 108 (66.6%), happened within 6–24 months of treatment completion.
ConclusionDespite treatment barriers, overall response and outcome were non-inferior and comparable to Western data. High-grade DLBCL, T-NHL, advanced stage, poor IPI attributed to suboptimal response and inferior survival, thus emphasizing novel prognostic markers and biological agents based on high-risk molecular signature to enable individualized treatment.