Non-Hodgkin lymphoma natural history, complications and prognosis: Difference between revisions

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{{Non-Hodgkin lymphoma}}  
{{Non-Hodgkin lymphoma}}  
{{CMG}}
{{CMG}} {{AE}} {{Preeti}}
==Overview==
Common complications of non-Hodgkin lymphoma include lymphadenopathy, disseminated intravascular coagulation, superior vena cava (SVC) syndrome, [[autoimmune hemolytic anemia]] and [[infection]]. The indolent non-Hodgkin lymphoma types are associated with a relatively good prognosis. The 5-year relative survival rate of patients with NHL is 71.4%.
 
== Natural History ==
 
==Complications==
Common complications of non-Hodgkin lymphoma include:<ref name="pmid25921177">{{cite journal| author=Dehghani M, Haddadi S, Vojdani R| title=Signs, Symptoms and Complications of Non-Hodgkin's Lymphoma According to Grade and Stage in South Iran. | journal=Asian Pac J Cancer Prev | year= 2015 | volume= 16 | issue= 8 | pages= 3551-7 | pmid=25921177 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25921177  }} </ref>
*[[Lymphadenopathy]] especially cervical [[lymphadenopathy]]
*Cytopenias such as [[neutropenia]], [[anemia]] and [[thrombocytopenia]] secondary to bone marrow infiltration
*[[Autoimmune hemolytic anemia]]
*Bleeding secondary to [[thrombocytopenia]]
*[[Disseminated intravascular coagulation (patient information)|Disseminated intravascular coagulation (DIC)]]
*Infection secondary to [[neutropenia]]
*Cardiac problems secondary to large [[pericardial effusion]]
*[[Cardiac arrhythmias]] secondary to cardiac metastases
*Respiratory problems secondary to [[pleural effusion]]
*[[Superior vena cava (SVC) syndrome]] secondary to a large mediastinal tumor
*Spinal cord compression secondary to vertebral metastases
*Neurologic problems secondary to [[primary CNS lymphoma]] or lymphomatous [[meningitis]]
*Gastrointestinal obstruction, perforation, and bleeding in a patient with [[MALT lymphoma]]
*Pain secondary to [[tumor]] invasion
*[[Lymphocytosis]] in leukemic phase of disease


==Overview==
==Prognosis==
*The 5-year relative survival rate of patients with NHL is 71.4%.<ref name="pmid21224370">{{cite journal| author=Abla O, Weitzman S, Blay JY, O'Neill BP, Abrey LE, Neuwelt E et al.| title=Primary CNS lymphoma in children and adolescents: a descriptive analysis from the International Primary CNS Lymphoma Collaborative Group (IPCG). | journal=Clin Cancer Res | year= 2011 | volume= 17 | issue= 2 | pages= 346-52 | pmid=21224370 | doi=10.1158/1078-0432.CCR-10-1161 | pmc=4058714 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21224370  }} </ref>
*The survival rate has steadily improved over the last 2 decades, thanks to improvements in medical and nursing care, the advent of novel therapeutic strategies (ie, [[monoclonal antibodies]]), validation of biomarkers of response, and the implementation of tailored treatment.
*The prognosis for patients with NHL depends on the following factors:<ref name="pmid21224370">{{cite journal| author=Abla O, Weitzman S, Blay JY, O'Neill BP, Abrey LE, Neuwelt E et al.| title=Primary CNS lymphoma in children and adolescents: a descriptive analysis from the International Primary CNS Lymphoma Collaborative Group (IPCG). | journal=Clin Cancer Res | year= 2011 | volume= 17 | issue= 2 | pages= 346-52 | pmid=21224370 | doi=10.1158/1078-0432.CCR-10-1161 | pmc=4058714 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21224370  }} </ref>
**Tumor histology
**Tumor stage
**Patient age
**Tumor bulk
**Performance status
**[[Serum lactate dehydrogenase]] (LDH) level
**[[Beta2-microglobulin]] level
 
===Prognostic Indexes===
====International Prognostic Index (IPI)====
*The International Prognostic Index (IPI), which was originally designed as a prognostic factor model for aggressive non Hodgkin lymphoma (NHL) appears to be useful for predicting the outcome of patients with low-grade lymphoma and [[mantle cell lymphoma]].<ref name="pmid21224370">{{cite journal| author=Abla O, Weitzman S, Blay JY, O'Neill BP, Abrey LE, Neuwelt E et al.| title=Primary CNS lymphoma in children and adolescents: a descriptive analysis from the International Primary CNS Lymphoma Collaborative Group (IPCG). | journal=Clin Cancer Res | year= 2011 | volume= 17 | issue= 2 | pages= 346-52 | pmid=21224370 | doi=10.1158/1078-0432.CCR-10-1161 | pmc=4058714 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21224370  }} </ref><ref name="pmid26384083">{{cite journal| author=Shalabi H, Angiolillo A, Vezina G, Rubenstein JL, Pittaluga S, Raffeld M et al.| title=Prolonged Complete Response in a Pediatric Patient With Primary Peripheral T-Cell Lymphoma of the Central Nervous System. | journal=Pediatr Hematol Oncol | year= 2015 | volume= 32 | issue= 8 | pages= 529-34 | pmid=26384083 | doi=10.3109/08880018.2015.1074325 | pmc=4942274 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26384083  }} </ref>
*This index is used to identify patients at high risk of relapse, based on specific sites of involvement, including [[Bone marrow abnormality|bone marrow]], [[Brain abscess|CNS]], liver, testis, lung, and spleen.
*Clinical features included in the IPI that are independently predictive of survival include the following:
**Age - Younger than 60 years versus older than 60 years
**LDH level - Within the reference range versus elevated
**Performance status - Eastern Cooperative Oncology Group ( ECOG) grade 0-1 versus 2-4
**Ann Arbor stage - Stage I-II versus III-IV
**Number of extranodal sites - Zero to 1 versus more than 1
*With this model, relapse-free and overall survival rates at 5 years are as follows:
**0-1 risk factors - 75%
**2-3 risk factors - 50%
**4-5 risk factors - 25%


==References==
==References==
{{reflist|2}}
{{reflist|2}}
{{Hematology}}
{{Hematological malignancy histology}}
{{SIB}}
[[bn:অ-হজকিনের লসিকার্বুদ]]
[[de:Non-Hodgkin-Lymphom]]
[[es:Linfomas no-Hodgkins]]
[[fr:Lymphome non-hodgkinien]]
[[nl:Non-Hodgkin]]
[[ja:非ホジキンリンパ腫]]
[[pl:Chłoniaki nieziarnicze]]
[[pt:Linfoma não-Hodgkin]]
[[fi:Non-Hodgkinin lymfooma]]
[[sv: Non-Hodgkins lymfom]]


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Latest revision as of 20:44, 21 January 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Preeti Singh, M.B.B.S.[2]

Overview

Common complications of non-Hodgkin lymphoma include lymphadenopathy, disseminated intravascular coagulation, superior vena cava (SVC) syndrome, autoimmune hemolytic anemia and infection. The indolent non-Hodgkin lymphoma types are associated with a relatively good prognosis. The 5-year relative survival rate of patients with NHL is 71.4%.

Natural History

Complications

Common complications of non-Hodgkin lymphoma include:[1]

Prognosis

  • The 5-year relative survival rate of patients with NHL is 71.4%.[2]
  • The survival rate has steadily improved over the last 2 decades, thanks to improvements in medical and nursing care, the advent of novel therapeutic strategies (ie, monoclonal antibodies), validation of biomarkers of response, and the implementation of tailored treatment.
  • The prognosis for patients with NHL depends on the following factors:[2]

Prognostic Indexes

International Prognostic Index (IPI)

  • The International Prognostic Index (IPI), which was originally designed as a prognostic factor model for aggressive non Hodgkin lymphoma (NHL) appears to be useful for predicting the outcome of patients with low-grade lymphoma and mantle cell lymphoma.[2][3]
  • This index is used to identify patients at high risk of relapse, based on specific sites of involvement, including bone marrow, CNS, liver, testis, lung, and spleen.
  • Clinical features included in the IPI that are independently predictive of survival include the following:
    • Age - Younger than 60 years versus older than 60 years
    • LDH level - Within the reference range versus elevated
    • Performance status - Eastern Cooperative Oncology Group ( ECOG) grade 0-1 versus 2-4
    • Ann Arbor stage - Stage I-II versus III-IV
    • Number of extranodal sites - Zero to 1 versus more than 1
  • With this model, relapse-free and overall survival rates at 5 years are as follows:
    • 0-1 risk factors - 75%
    • 2-3 risk factors - 50%
    • 4-5 risk factors - 25%

References

  1. ↑ Dehghani M, Haddadi S, Vojdani R (2015). "Signs, Symptoms and Complications of Non-Hodgkin's Lymphoma According to Grade and Stage in South Iran". Asian Pac J Cancer Prev. 16 (8): 3551–7. PMID 25921177.
  2. ↑ 2.0 2.1 2.2 Abla O, Weitzman S, Blay JY, O'Neill BP, Abrey LE, Neuwelt E; et al. (2011). "Primary CNS lymphoma in children and adolescents: a descriptive analysis from the International Primary CNS Lymphoma Collaborative Group (IPCG)". Clin Cancer Res. 17 (2): 346–52. doi:10.1158/1078-0432.CCR-10-1161. PMC 4058714. PMID 21224370.
  3. ↑ Shalabi H, Angiolillo A, Vezina G, Rubenstein JL, Pittaluga S, Raffeld M; et al. (2015). "Prolonged Complete Response in a Pediatric Patient With Primary Peripheral T-Cell Lymphoma of the Central Nervous System". Pediatr Hematol Oncol. 32 (8): 529–34. doi:10.3109/08880018.2015.1074325. PMC 4942274. PMID 26384083.
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