The prognostic significance of POD24 in 106 cases with splenic marginal lymphoma with bone marrow invasion / 中华血液学杂志

Objective: To explore the effect of progression of disease within 24 months (POD24) on overall survival (OS) of splenic marginal lymphoma (SMZL) with bone marrow invasion, and to compare the clinical characteristics between POD24 SMZL with non-POD24 SMZL patients. Methods: The SMZL patients with bone marrow invasions were retrospectively analyzed between January 2002 and January 2017 treated in our institute, and the patients with sufficient follow-up time to judge POD24 were evaluated the clinical characteristics and prognosis, patients who died of non-progressive factors were excluded. Results: 106 patients were enrolled with a median age of 57 (25-79) years old. ①Clinical characteristics: All patients presented with bone marrow invasion and splenomegaly, 59.4% (63/106) with huge spleen, 14.8% (15/101) with hepatomegaly. Complex karyotype were found in 22.7% (18/79) patients; 13q deletion, 11q (ATM) deletion, 17p (TP53) deletion, and CEP12 abnormality patients presented with the percentage of 5.1% (4/78) , 1.3% (1/72) , 2.5% (2/80) , and 7.5% (4/53) , respectively.②Survival analysis: Univariate analysis showed that POD24, HGB less than 100 g/L and FISH detection of trisomy 12 were poor prognostic factors of OS. Multivariate analysis showed that only POD24 had independent prognostic significance[HR=20.116 (95%CI 2.226-181.820) , P=0.008]. ③Subgroup features: Patients with POD24 had significantly higher rates of mediastinal lymphadenopathy (63.6%vs 18.9%, P=0.005) and complex karyotype (50.0%vs 17.9%, P=0.024) than those without POD24. While the incidence of abdominal lymphadenopathy, anemia, thrombocytopenia, the lower albumin, and the increasing lactate dehydrogenase were higher in POD24 patients, but with no statistically difference. Conclusion: POD24 is an independent prognostic factor of the OS in SMZL. SMZL patients with mediastinal lymphadenopathy and complex karyotypes when diagnosed have a higher risk of POD24.

Invasão de medula óssea por linfoma não-Hodgkin difuso de grandes células B: relato de caso / Bone marrow involvement in diffuse large B-cell non-Hodgkin lymphoma: case report

JUSTIFICATIVA E OBJETIVOS: Relatar o início precoce do tratamento em um caso de linfoma não-Hodgkin com invasão de medula óssea. RELATO DO CASO: Paciente do sexo masculino, 55 anos, admitido no serviço de Hematologia do Hospital Ana Costa, com quadro clínico sugestivo de linfoma não-Hodgkin. CONCLUSÃO: A avaliação adequada e minuciosa do esfregaço do sangue periférico ainda é um excelente método diagnóstico e tratamento desta doença.

BACKGROUND AND OBJECTIVES: To report early treatment in a case of non-Hodgkin's lymphoma with bone marrow invasion. CASE REPORT: A male patient, 55 years old, admitted to Ana Costa Hospital hematologic service, with clinical symptoms suggestive of non-Hodgkin's lymphoma. CONCLUSION: A thorough and proper evaluation of peripheral blood smear is still an excellent method for diagnosis and treatment of this disease.