Yaygın büyük B hücreli lenfoma tanılı hastalarda,CD30 pozitifliğinin klinik bulgularla ilişkisinindeğerlendirilmesi
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Tarih
2023
Yazarlar
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Yayıncı
Necmettin Erbakan Üniversitesi Meram Tıp Fakültesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Yaygın Büyük B Hücreli Lenfoma (YBBHL) tanılı hastalarda, CD30 pozitifliğinin klinik bulgular ile ilişkisinin değerlendirilmesi amaçlanmaktadır.
Yöntem: Çalışmamızda Ocak 2005-Kasım 2022 tarihleri arasındaki Necmettin Erbakan Üniversitesi Tıp Fakültesi Hematoloji kliniğine başvuran YBBHL tanısı ile takip ve tedavi edilen hastalar incelendi. Hastaların tanı anındaki demografik özellikleri, temel laboratuvar bulguları, hastalık evresi ve hastalığa özel risk skorlaması ve hastalığın tutulum bölgeleri kaydedildi. Öte yandan ilk uygulanan tedavi rejimi, ilk tedaviye yanıtı, tanı sonrası takiplerinde progresyon durumu, otolog ya da allojenik kök hücre transplantasyon öyküsü ve sağ kalım durumları değerlendirildi. Hastalar tanı anındaki preparatlardaki immunhistokimyasal boyanma özelliğine göre CD30 pozitif ve negatif olmak üzere iki gruba ayrıldı ve iki grup tanı anındaki özellikleri, progresyon ve sağ kalım açısından açısından karşılaştırıldı.
Bulgular: Çalışmamıza 111 hasta dahil edildi. Hastaların 18’i CD30(+), 93’ü CD30 (-)’ti. CD30(+)’lerde kalsiyum değeri medyan 8,8 mmol/L iken CD30 (-)’lerde 9,2 mmol/L olup CD30(-) hastalarda istatistiksel olarak anlamlı yüksek bulundu (p:0,013). Tahmini medyan toplam sağ kalım (TSK), CD30 (+) hastalarda istatistiksel olarak anlamlı olmamakla birlikte düşük bulundu (36,9 aya karşın 100,9 ay, p:0,155). Tahmini medyan progresyonsuz sağ kalım (PSK)’da CD30 (+) hastalarda istatistiksel olarak anlamlı olmamakla birlikte düşüktü (37 aya karşın 100,9 ay, p:0,849). 2 yıllık TSK sırayla CD30(+) ve (-)
vi
hastalarda %70’e karşın %84, 3 yıllık TSK ise %42’ye karşın %67 oranında bulundu. İki yıllık PSK ise sırayla %50’ye %80 oranında hesaplandı. Beş yıllık PSK CD30(+) hasta grubunda hesaplanamazken, CD30(-)’lerde %60 bulundu.
Sonuç: Çalışmamız YBBHL CD30(-) hasta grubunda kalsiyum anlamlı yüksek bulundu. Literatürde yeterli veri olmaması, serum kalsiyum ile CD30’u karşılaştıran daha fazla çalışma gereksinimini ortaya koymuştur. Toplam ve progresyonsuz sağ kalım ile CD30 arasında anlamlı farklılık bulunmadı. YBBHL CD30(+) ve (-) hastalarının epidemiyolojik bulguları, laboratuvar, klinik özellikleri ve sağ kalım sonuçları karşılaştırıldığında bulunan benzerlik ve farklılıkların, CD30(+) hastalara yaklaşım ve tedavilerinin farklı olması gerektiği konusundan tam bir ilişki ortaya koyamazken; daha kapsamlı çalışmalar yapılması gerektiği konusunda fikir vericidir.
Objective: It is aimed to evaluate the relationship of CD30 positivity with clinical findings in patients diagnosed with diffuse large B-cell lymphoma (DBBHL). Materials and methods: January 2005-November 2022, patients who were admitted to Necmettin Erbakan University Faculty of Medicine Hematology clinic and followed up and treated with the diagnosis of DBBHL were examined in our study. Demographic characteristics of the patients at the time of diagnosis, basic laboratory findings, disease stage and disease-specific risk scoring and the regions of involvement of the disease were recorded. On the other hand, the first treatment regimen applied, the response to the first treatment, the progression status of the follow-up after diagnosis, the history of autologous or allogeneic stem cell transplantation and the survival status were evaluated. Patients were divided into two groups, CD30 positive and negative, according to the immunohistochemical staining property of the preparations at the time of diagnosis, and the two groups were compared in terms of their characteristics at the time of diagnosis, progression and survival. Results: 111 Patients were included in our study. 18 Of the patients were CD30(+), 93 of them were CD30 (-). While the median calcium value in CD30(+) was 8.8 mmol/L, it was found to be 9.2 mmol/L in CD30 (-) and statistically significantly higher in CD30(-) patients (p:0.013). Estimated median overall survival (OS) was found to be low in CD30 (+) patients, although not statistically significant (36.9 months versus 100.9 months, p:0.155). The estimated median viii progression-free survival (PFS) was low, although not statistically significant, in CD30 (+) patients (37 months versus 100.9 months, p:0.849). 2-year OS was found to be 70% versus 84% in CD30(+) and (-) patients respectively, and 3-year OS was found to be 42% versus 67%. The two-year PFS was calculated at 50% and 80% respectively. While the five-year PFS could not be calculated in the CD30(+) patient group, it was found to be 60% in CD30(-) patients. Conclusion: Our study found a significant increase in calcium in the DBBHL CD30(-) patient group. The lack of sufficient data in the literature has revealed the need for more studies comparing serum ca and CD30. There was no significant difference between total and progression-free survival and CD30. While the epidemiological findings, laboratory, clinical characteristics and survival results of DBBHL CD30(+) and (-) patients cannot reveal a complete relationship between the similarities and differences found when compared, the approach and treatment of CD30(+) patients should be different; it gives an idea that more comprehensive studies should be conducted.
Objective: It is aimed to evaluate the relationship of CD30 positivity with clinical findings in patients diagnosed with diffuse large B-cell lymphoma (DBBHL). Materials and methods: January 2005-November 2022, patients who were admitted to Necmettin Erbakan University Faculty of Medicine Hematology clinic and followed up and treated with the diagnosis of DBBHL were examined in our study. Demographic characteristics of the patients at the time of diagnosis, basic laboratory findings, disease stage and disease-specific risk scoring and the regions of involvement of the disease were recorded. On the other hand, the first treatment regimen applied, the response to the first treatment, the progression status of the follow-up after diagnosis, the history of autologous or allogeneic stem cell transplantation and the survival status were evaluated. Patients were divided into two groups, CD30 positive and negative, according to the immunohistochemical staining property of the preparations at the time of diagnosis, and the two groups were compared in terms of their characteristics at the time of diagnosis, progression and survival. Results: 111 Patients were included in our study. 18 Of the patients were CD30(+), 93 of them were CD30 (-). While the median calcium value in CD30(+) was 8.8 mmol/L, it was found to be 9.2 mmol/L in CD30 (-) and statistically significantly higher in CD30(-) patients (p:0.013). Estimated median overall survival (OS) was found to be low in CD30 (+) patients, although not statistically significant (36.9 months versus 100.9 months, p:0.155). The estimated median viii progression-free survival (PFS) was low, although not statistically significant, in CD30 (+) patients (37 months versus 100.9 months, p:0.849). 2-year OS was found to be 70% versus 84% in CD30(+) and (-) patients respectively, and 3-year OS was found to be 42% versus 67%. The two-year PFS was calculated at 50% and 80% respectively. While the five-year PFS could not be calculated in the CD30(+) patient group, it was found to be 60% in CD30(-) patients. Conclusion: Our study found a significant increase in calcium in the DBBHL CD30(-) patient group. The lack of sufficient data in the literature has revealed the need for more studies comparing serum ca and CD30. There was no significant difference between total and progression-free survival and CD30. While the epidemiological findings, laboratory, clinical characteristics and survival results of DBBHL CD30(+) and (-) patients cannot reveal a complete relationship between the similarities and differences found when compared, the approach and treatment of CD30(+) patients should be different; it gives an idea that more comprehensive studies should be conducted.
Açıklama
Anahtar Kelimeler
Yaygın Büyük B Hücreli Lenfoma, CD30, Toplam Sağ Kalım, Progresyonsuz Sağ Kalım, Diffuse Large B Cell Lymphoma, CD30, Overall Survival, Progression Free Survival
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Scopus Q Değeri
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Künye
Alpsoy, H. P. (2023). Yaygın büyük B hücreli lenfoma tanılı hastalarda,CD30 pozitifliğinin klinik bulgularla ilişkisinin değerlendirilmesi. (Yayınlanmamış tıpta uzmanlık tezi) Necmettin Erbakan Üniversitesi, Meram Tıp Fakültesi Dahili Tıp Bilimleri Bölümü İç Hastalıkları Anabilim Dalı, Konya.
