The Hodgkin lymphoma treatment is adapted to the disease type, disease stage and to an evaluation of the risk. The treatment is focused on the adjustment of the therapy to each patient depending on the age, toxicity risk on short and long term and the relapse risk. The study proposes the evaluation of the response to the treatment further to the administration of different therapeutic regimens as well as the correlation with the negative diagnosis factors of Hodgkin lymphoma. This is a retrospective study on 71 patients diagnosed with Hodgkin lymphoma in the Hematology Department of Timisoara between January 2014 and December 2017. The data obtained have been collected from a database and processed with the SPSS 20.0. software . In our study there were included 71 patients diagnosed with Hodgkin lymphoma with a medium age of 42.12�16.45 years old. By the time of the diagnosis, the patients showed the following hematological, biochemical and immunological parameters. The response to treatment is influenced by the presence of the negative prognosis factors : the age of �40 years old, extralymphatic infiltration, VSH ] 50mm/h , presence of general B signs, more than 3 lymph node sites affected, bulky disease and Ann-Arbor III and IV stages. The treatment of Hodgkin lymphoma is guided by the traditional clinic prognostic factors and by the laboratory which often represent a substitute marker for the biological characteristics which many times are not included in the standard evaluation.
Background and objectives: Hodgkin lymphoma (HL) is characterized by the presence of malignant Reed Sternberg cells. Although the current curability rate in patients with HL has increased, up to 30% of those in the advanced stages and 5% to 10% of those in limited stages of the disease, relapse. According to the studies, the relapse risk in HL decreases after 2 years. The purpose of this study is to evaluate the relapse risk and event free survival (EFS) in patients with HL treated with Doxorubicin, Bleomycin, Vinblastine and Dacarbazine (ABVD), or treated with Bleomycin, Etoposide, Doxorubicin, Cyclophosphamide, Vincristine, Procarbazine, and Prednisone (BEACOPP) regimens. Material and methods: In an observational, consecutive-case scenario, 71 patients (median age 32 years; range 16 to 80 years) diagnosed within a 4-year timeframe were enrolled; all patients were treated according to standards of care. The average follow-up duration was 26 months. Results: The risk of relapse, in patients older than 40 years, decreased after 1 year, OR = 0.707 (95% CI 0.506 to 0.988), and 2 years, OR = 0.771 (95% CI 0.459 to 1.295), respectively. Patients in the advanced stages had a higher International Prognostic Score (IPS) (score ≥ 4). The overall survival at 2 years was 57.74% and the disease-specific survival at 2 years was 71.83%. Regardless, the chemotherapy regimen and the EFS time, advanced stage, high IPS and bulky disease were still associated with an increased relapse risk in patients with HL. Conclusions: The use of ABVD chemotherapy regimen followed by 2 years EFS was associated with a reduced relapse risk.
Many prognostic factors for HL have been proposed in the past and some of these were included in several prognostic scores. Tumor stage and spread, age, gender and various biological parameters are considered to have an effect on disease evolution, with the prognostic scores stratifying patients into risk groups and guiding the course of treatment. In the present study we have enrolled 54 patients with Hodgkin�s lymphoma admitted in the Hematology Department within the City Emergency Clinical Hospital Timisoara over a 4-year period. We aimed to see if a statistically significant correlation can be made between hemoglobin, white blood cell, lymphocyte, eosinophil, monocyte and platelet levels at the time of diagnosis on the one hand, and response to treatment and patients� survival, on the other hand. Patients� response to treatment was evaluated according to Cheson criteria, with best response to the combination of ABVD(doxorubicin C27H29NO11, bleomycin C55H84N17O21S3, vinblastine C46H58N4O9, dacarbazine C6H10N6O) and radiation therapy. Response to treatment was also influenced by eosinophil levels at diagnosis and this has effects on survival. Finally, lymphocyte and platelet levels at diagnosis correlated with survival times in our study group. Therefore, eosinophil, lymphocyte and platelet levels at diagnosis could be considered as prognostic factors for HL, although further studies are needed to validate our findings.
Aims: Assessment of the intensity of the JAK2 V617F mutation prevalence on the age and sex dependence using the model of the "second order phase transition''. Methods: The data base of the Krasnoyarsk branch of the National Hematology Research Center from Jan 2012 to Feb 2019 examination has been used. The JAK2V617F allele burden was measured in whole blood samples by an allele-specific quantitative polymerase chain reaction using of the "Myeloskrin JAK2 kit'' (Formula of gene ltd). The relationship between the q (rate of JAK2 V617F detection) and the 1/T indicator ("reverse age'') in each age-old five-year cohort on 1154 men and 958 women referred with suspicion of MPN was studied. The values of q 2 should be close to zero as according to the model of second order phase transitions for physical systems until reaching a certain critical patients age Tc and the relationship between the q 2 and 1/T variables will be described by the equation q 2 = a-b/T with an angular coefficient b characterizing the increase in the intensity of the mutational burden with age after reaching the critical age T c . Results: Using of our model led to transforms the monotonous growth curve of mutation prevalence with age. The value of q 2 is close to zero at high values of 1/T (young patients) and for smaller values of 1/T (more older age) the relationship between q 2 and 1/T becomes linear (figure). The hypothesis of the statistical significance differences of regression for male and female was tested by Fisher test for the significance level a=5%. Hypothesis of the absence of differences between the two regressions is not rejected. The critical age of patients transition to the phase with a high risk of mutation development corresponds for male T c = 48.8 years and for female T c = 36.0 years. Intensity of further accumulation of the mutation burden in male b = 44.35 ± 12.86, in female b = 27.52 ± 4.57. Summary/Conclusion:The "second order phase transitions model'' it possible to introduce in the population analysis the indicators of the "critical age'' T c and the intensity of accumulation of the burden of mutations b. This estimate are not significantly different for male and female for our sample. The calculated critical age turned out to be significantly lower than the median of the age of diagnosis of MPN (53 and 57 years). The proposed model will be useful for analyzing the characteristics of the population of MPN in different cohorts, as well as in different social and environmental conditions of life.
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