12th Congress of the European Hematology ... - Haematologica

0705
THE SHIFT OF TREATMENT FOR NASAL AND NASAL-TYPE NK/T CELL LYMPHOMA,TEN
YEARS EXPERIENCE AND PROGNOSTIFICATION ANALYSIS IN A SINGLE INSTITUTION
T.D. Tan, M. Lee
Koo Foundation Sun Yat-Sen Cancer Center, TAIPEI, Taiwan
Background. For nasal and nasal-type NK/T cell lymphoma the prognosis
is poor,the two-year survival ranges from 20% to 40%,and there
is no standard modality of treatment. Even patients presented with limited
stages of disease undergoing radiotherapy with or without
chemotherapy,there are substantial percentage of patients died of local
tissue destruction complicated with infection and/or distant relapse of
disease. Aims. We are looking for the best modality of treatment in the
past 10 years (1996~2006) at our hospital to achieve better survival for
these patients. We are also in search of the impact of immunophenotypes
and treatment modalities upon survival. Methods. This is a retrospective
observation study to treat 27 patients of nasal and nasal-type NK/T cell
lymphoma at out hospital from 1996 to 2006 in three periods of time.
In the first period, from 1996 to 2002,we treated 16 patients with radiation
alone or CHOP chemotherapy followed by radiotherapy. In the
second period,from 2002 to 2004,we treated 5 patients with more intensive
induction chemotherapy BFM-90 protocol followed by radiotherapy.
In the third period, from 2004 to 2006, we treated 6 patients with
concurrent chemoradiotherapy (CCRT) with ICE. Results. For total 27
patients, the 2-,3-,and 5-year overall survival are 45%,33%,and 33%,
respectively, and it seems to be in plateau until 84 months. For 16
patients, 5 patients, and 6 patients treated in the 1st , 2nd ,and 3rd periods
of times, the overall survival are 25%,40%, and 66.6%,respectively. For
CD3 – / CD56 + compared with CD3 + /CD56 + patients, the 5-year overall
survival are 80% and 19%,respectively (p value 0.10). For CD4 – /CD8 –
compared with other patients, the 5-year overall survival are 67% and
21%,respectively (p value 0.037). For patients undergoing CCRT compared
with sequential treatment, the 3-year overall survival are 57% and
33%,respectively (p value 0.27).For patients underwent more intensive
chemotherapy as compared with CHOP, the 5-year overall survival are
64% and 25%, respectively (p value 0.08). Conclusions. Concurrent
chemoradiotherapy is better than sequential chemoradiotherapy and
more intensive chemotherapy has better overall survival than CHOP
chemotherapy. CD3 – /CD56 + and CD4 – /CD8 – NK/T cell lymphomas
have better prognosis.
Figure 1.
0706
PRIMARY EXTRANODAL FOLLICULAR LYMPHOMA: CLINICOBIOLOGICAL FEATURES AND
OUTCOME
S. Mercadal, 1 S. Marcadal, 1 A. Martinez-Pozo, 1 F. Bosch, 1 E. Giné, 1
A. Muntanola, 1 S. Montoto, 2 L. Colomo, 1 O. Balagué, 1 O. Salamero, 1 G.
Gutierrez-Garcia, 1 P. Abrisqueta, 1 E. Campo, 1 E. Montserrat, 1
A. Lopez-Guillermo1 1 2 Hospital Clinic, BARCELONA, Spain; St. Bartholomew's Hospital, LON-
DON, United Kingdom
Background. Follicular lymphoma (FL) is typically a nodal disease. Pri-
mary extranodal FLs, that represent less than 10% of the cases, might
have differentiated clinicobiological features. Aims. To analyze the main
clinicobiological characteristics, response to therapy and outcome of a
series of patients with FL primarily extranodal in origin, and compare
them with nodal FLs. Methods. Seventeen patients (10M/7F; median age,
61 years) with FL and primary origin in extranodal location, diagnosed
at a single institution during a 25-year period, were the subject of the
study. Skin FL was excluded from the study. The control group was constituted
by 212 patients with nodal FL diagnosed during the same period
of time. Main clinicobiological features were recorded and analyzed.
Results. The sites of the primary disease were: Waldeyer’s ring, 4; GI
tract, 3; bone marrow, CNS and parotid (two cases each); and pancreas,
thyroid, kidney and orbit (one case each). Main histological and clinical
features are listed in the table. Treatment was given without considering
the nodal or extranodal origin of the disease and consisted of:
monotherapy with alkylating agents (35 cases), polychemotherapy (122),
and fludarabine alone or with other drugs (14) and others, including surgery
and observation (58). CR rate was higher in extranodal than in
nodal FL (85% vs. 53%, respectively; p=0.02), but no differences were
found in overall survival. FLIPI score was the most significant variable
predicting overall survival in the global series as well as in either in nodal
or extranodal FL. Summary. Extranodal FL have some peculiar clinicobiological
features with respect to nodal cases. Regarding the outcome,
although patients with extranodal FL showed a higher CR rate, the overall
survival was similar in both groups.
Table 1.
12 th Congress of the European Hematology Association
0707
ANALYSIS OF 136 REPORTED HAEMATOLOGICAL AUTOIMMUNE CASES IN NHL
A. Hauswirth, C. Skrabs, U. Jäger, K. Lechner
Medical University of Vienna, VIENNA, Austria
Background. Haematological autoimmune complications are relatively
common in CLL but are much less common in NHL. In large studies
the prevalence of autoimmune hemolytic anemia (AIHA) is 1,57%, of
autoimmune thrombocytopenia (AITP) is 0,76% and of Evans-syndrome
0,18%. Methods. We have analysed 136 individual cases of NHL (excluding
CLL) associated AIHA, AITP and Evans-syndrome reported in the literature
(88 cases of AIHA, 34 cases with AITP and 14 with Evans-syndrome)
with regard to demographic factors, prevalence in subtypes and
treatment response. Results. The median age of all patients was higher
than in idiopathic cases. In contrast to idiopathic AIHA and AITP there
was no female sex prevalence. In AIHA the sex prevalence was different
in subtypes. AIHA and AITP occurred in all subtypes in NHL with
the exception of AIHA in mantle cell-lymphoma (no case). There was of
high prevalence of localized of extranodal early stage lymphomas (in
particular in DLCL). In both AIHA and AITP sustained responses to
steroids and HD-IgG were uncommon. Splenectomy had high efficacy
only in SLVL. Surgical removal of extranodal lymphomas and/or
chemotherapy was effective in about half of the cases. The mortality was
higher in AIHA than in AITP. Rituximab was effective in some highly
refractory cases of AITP and AIHA. Conclusions. This compilation of data
indicates a complex relation of lymphoma and AIHA/AITP and warrants
more attention and specific studies.
haematologica/the hematology journal | 2007; 92(s1) | 263