Analysis of prognostic factors in 108 patients with non-Hodgkin’s lymphoma

Abstract

Objective

To analyze the prognostic factors in patients with non-Hodgkin’s lymphoma (NHL) and to investigate the prognostic value of the absolute lymphocyte count (ALC) in peripheral blood in NHL patients at admission.

Methods

The clinical features and follow-up data from 108 NHL patients whose diagnosis was confirmed through pathologic examination during a period from January 2000 to January 2008 were reviewed. SPSS 14.0 package was used for statistical analysis, and the Kaplan-Meier curve method for assessment of survival probability. Furthermore, the Cox regression model was utilized for multivariate analysis for all parameters which were statistically significant and confirmed by univariate analysis.

Results

In the 108 NHL patients, the male-female ratio was approximately 1.5: 1 and the median age was 48 years. Before treatment, 61.1% of the patients had stage I and II disease, based on the Ann Arbor Clinical Classification. The ECOG performance status (PS) score reached a range from 0 to 1 in about 93% of total patients, and an elevated serum lactate dehydrogenase (LDH) was seen in 19.2%. Based on the international prognostic index (IPI) score, 80.6% of patients were in the low risk group. On admission, 35.2% of patients had an ALC ≤ 1 × 10⁹/L. Anemia, i.e. hemoglobin (Hb) ≤ 110 g/L was seen in 29.6% and B-symptoms in 26.9% of patients. The mean value of Hb was 129.2 ± 17.5 g/L in patients with ALC > 1 × 10⁹/L (n = 70) and 98.1 ± 20.6 g/L in those with ALC ≤ 1 × 10⁹/L (n = 38), and the difference between the 2 groups was statistically significant (P < 0.05). With a median follow-up period of 2 years, the median survival time was 2.3 years among all patients. The 2-year and 5-year overall survival (OS) rates were 73.2% and 39.6%, respectively. It was shown by univariate analysis that ALC ≤ 1 × 10⁹/L, Hb ≤ 110 g/L, B-symptoms, and the IPI ≥ 2 were statistically significant unfavorable prognostic factors in NHL patients. Multivariate analysis revealed that ALC ≤ 1 × 10⁹/L, B-symptoms, and the IPI ≥ 2 were independent unfavorable prognostic factors in NHL patients.

Conclusion

The numerical value of ALC and the presence of B-symptoms are prognostic factors independent of IPI in NHL patients. Clinically, determining prognosis based on the IPI combined with simple clinical parameters, such as the numerical value of ALC and B-symptom status, might be of more practical value in determining individualized treatment regimens for NHL patients.