Clinical Features And Prognostic Factors Of Hodgkin'S Lymphoma: A Single Center Experience

Background: Hodgkin's lymphoma (HL) is a B cell lymphoma characterized by the presence of Reed-Sternberg cells. HL comprises 1% of all cancer cases and 14% of all lymphoma cases. Aims: We designed a retrospective study to investigate the clinical features and prognostic factors of HL patients diagnosed at an experienced oncology centre. Study Design: Retrospective study. Methods: Demographic characteristics, histopathological and clinical features, treatment modalities and response to treatment were obtained from hospital records. Dates of initial diagnosis, remission and relapse, last visit and death were recorded for survival analyses. Results: We analysed data of 391 HL patients (61% male, 39% female; mean age 35.7+/-15.1 years). The most common classical HL histological subtype was nodular sclerosing HL (NSHL) (42.7%). The most common stage was II 50.4%. The most common chemotherapy regimen was doxorubicin, bleomycin, vinblastine and dacarbazine (ABVD) (70.6%). Five and 10-year survival rates were 90% and 84%, respectively. Early-stage patients with good prognostic factors had better overall and relapse-free survival rates. The presence of "B" symptoms, albumin level, Eastern Cooperative Oncology Group (ECOG) performance score, and LDH were prognostic factors that affect the survival in both univariate and multivariate analyses. Conclusion: This is the first study that demonstrates the demographic, clinical and prognostic features of HL patients in Turkey, and provides a general picture of the HL patients in our country.WoSScopu

Non‐Hodgkin's Lymphomas In Turkey: Eighteen Years’Experience At The Hacettepe University

In this retrospective study, 470 patients with non‐Hodgkin's lymphoma (NHL) who had been followed in the Hacettepe University Medical Oncology Department between 1973 and 1990, were evaluated to establish their epidemiologic, clinical and therapeutic characteristics. Out of 470 patients, 302 (62.2%) were male and 168 (37.8%) were female. The ages ranged from 16 to 85, with a median of 44 years. Constitutional symptoms were present in 46.4% of the patients. According to the Working Formulation, low, intermediate, and high‐grade lymphomas comprised 33.4%, 54.9%, and 12.7%, respectively. The most common extranodal presentation was gastrointestinal. The chemotherapy regimens most commonly used were CVP (cyclophosphamide, vincristine, prednisone), BCNOP (bleomycin, cyclophosphamide, mitoxantrone, vincristine, prednisone), CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) and CHOP‐Bleo (cyclophosphamide, doxorubicin, vincristine, prednisone, bleomycin). The response rates and the survival figures attained with these regimens were not statistically significantly different (P > 0.05). In the Cox multivariate model, pathologic grade, leukopenia, responsiveness to chemotherapy, bone marrow involvement and age were the important factors influencing the disease‐free survival, while responsiveness to chemotherapy, age, presence of constitutional symptoms, pathologic grade, extranodal presentation and stage were the important factors influencing the overall survival. The distribution of NHL according to grade and stage was similar to that in western societies, while constitutional symptoms and lymphomas of the small intestine including immunoproliferative small intestinal disease were more common in Turkey.PubMedWo

Anthracyclin - Based Chemotherapy In Patients With Non-Hodgkin Lymphoma Aged Over 75

The optimal treatment of non-Hodgkin lymphoma (NHL) in elderly patients is controversial. In this study, we evaluated the outcomes for elderly patients who were treated with combined chemotherapy regimens. Patients with lymphoma aged over 75 treated at our Cancer Institute between 2005 and 2014 were evaluated retrospectively. Demographic data were collected from 76 elderly lymphoma cases receiving Rituximab-Chemotherapy, Chemotherapy only or Rituximab only. Survival or death during treatment were recorded, and lengths of progression-free survival (PFS) and overall survival (OS) were calculated. Seventy-six elderly patients with lymphoma were enrolled, 51.4% (n= 39) male and 48.6% (n= 37) female. Median age at diagnosis was 79 (75-95) years. Histopathological examination revealed diffuse large B cell lymphoma (DLBCL) in 52% (n= 40) of patients, follicular lymphoma in 21% (n= 16), marginal zone lymphoma in 10.5% (n= 8), mantle cell lymphoma in 5.3% (n= 4), and T cell lymphoma in 9.2% (n= 7). Median PFS and median OS were 50.1 and 45.9 months, respectively. In this trial, PFS and OS levels in the high grade lymphoma were not significantly different from those in the low and intermediate grade groups (p= 0.16 and p= 0.49 respectively). Comorbidity did not have a significant effect on PFS or OS (p= 0.71 and p= 0.93). In conclusion, anthracyclin-based chemotherapy regimens are not significantly better than the others in terms of PFS (p= 0.32) and OS (p= 0.8). Survival outcomes of anthracyclin-based chemotherapy regimens in elderly lymphoma patients are similar to those of non-anthracycline-based chemotherapy regimens.WoSScopu

2482. Impact Of A Recombinant Zoster Vaccine On Quality Of Life: Data From A Randomized, Placebo-Controlled, Phase 3 Trial In Adult Hematopoietic Stem Cell Transplant Recipients

Background Herpes zoster (HZ) and its complications can have a substantial impact on patients’ quality of life (QoL), particularly in immunocompromised patients. The vaccine efficacy (VE) of an adjuvanted recombinant zoster vaccine (RZV) was studied in a randomized, placebo-controlled, phase 3 study in adult hematopoietic stem cell transplant (HSCT) recipients (NCT01610414). The VE in preventing HZ cases was 68.2% (95% CI: 55.6%–77.5%). Herein we report the impact of the vaccine on patients’ quality of life (QoL) associated with HZ episodes. Methods HSCT recipients were randomized 1:1 to receive 2 doses of RZV or placebo, given 1–2 months apart and followed for the occurrence of HZ. QoL parameters were measured by the Short-Form health survey (SF-36) and Euro-Quality of Life-5 Dimension (EQ-5D) at baseline, 1 month and 1 year post-dose 2, as well as during suspected HZ episodes in conjunction with the Zoster Brief Pain Inventory (ZBPI). For confirmed HZ cases, QoL scores were compared between the vaccine and placebo groups. The RZV impact in reducing the ZBPI Burden of Illness and Burden of Interference scores was estimated in patients in the modified total vaccinated cohort (mTVC). The 2 scores were calculated from the area under the curve (Days 0 to 182) of the ZBPI Worst Pain and ZBPI Activities of Daily Living scores, respectively, assuming a score of 0 for patients who did not have a confirmed HZ episode. Results Both the ZBPI maximum Worst Pain and Average Pain scores were significantly lower in the vaccine than placebo group (Table 1), suggesting less burden in breakthrough HZ cases following RZV. Consequently, the HZ Burden of Illness and Burden of Interference VE estimates were higher than the HZ VE estimate. RZV showed statistically significantly better QoL scores than placebo one week following rash-onset among patients with confirmed HZ, i.e., SF-36 bodily pain, social functioning, role emotional, mental health and mental component scores, and the EQ-5D Utility Score., Conclusion In addition to reducing the risk of HZ and HZ complications, RZV significantly reduces the impact of HZ on patient’s QoL in those who develop breakthrough disease., Funding: GlaxoSmithKline Biologicals SA. Disclosures D. Curran, GlaxoSmithKline: Employee, GSK Shares and Salary. A. Bastidas, GSK: Employee, Salary. M. El Idrissi, GSK: Employee and Shareholder, Salary. S. Matthews, GSK group of companies: Consultant, Consulting fee. L. Oostvogels, GSK group of companies: Employee, Salary and stock and stock option. J. A. Young, GSK: Investigator, The University of Minnesota is reimbursed for contract costs associated with conducting clinical trials of vaccine. I receive no personal financial benefit