Clinical Features and Treatment Outcome of Patients with non-Hodgkin Lymphoma in Sawanpracharak Hospital

Abstract

Objective: To study the clinical manifestations and treatment outcome of patients with non-Hodgkin lymphoma (NHL) treated at Sawanpracharak Hospital. Materials and Methods: A retrospective analysis of 113 patients with newly diagnosed NHL treated from January 2005 to December 2009 was performed. Results: The mean age was 56.3 ± 13.6 years (range, 20-86), male:female ratio was 1:1.1. The most common histologic subtype was diffuse large cell lymphoma (66.4%), followed by follicular lymphoma (5.3%), and peripheral T-cell lymphoma (4.4%). Immunophenotypic data showed 89.2% of B cell and 9.9% of T cell lymphoma. Three patients (2.7%) had HIV infection. According to the International Prognostic Index (IPI), distribution of 91 patients with aggressivelymphoma were 29.6%, 22.0%, 25.3%, and 23.1% in low, low intermediate, high intermediate and high risk groups, respectively. Primary extranodal lymphomas comprised 36.3% of all patients and the most common site was gastrointestinal tract (39.0%). Most of the patients (77.9%) were treated with CHOP (cyclophosphamide, doxorubicin, vincristine and prednisone). Of the 98 evaluable patients, 52.0% achieved complete remission and 19.4% died during treatment. The 3-year overall survival rate was 37.6% (95%CI: 27.7-47.4) with a median followed-up time of 1.4 years (range, 26 days-6.7 years). According to IPI, the 3-year survival rate was signifi­cantly better in low/low intermediate risk group than in high intermediate/high risk group, (61.3% vs.15.3%, p < 0.001). Conclusion: Patients with NHL in the present study were comparable to published Thai data. The inferior survival particularly in high risk patients warranted improvement of supportive care and better access to evidence-based treatments with superior outcomes.