Prognosis in low grade non‐Hodgkin's lymphoma: relevance of the number of sites involved, absolute lymphocyte count and serum immunoglobulin level

Abstract

Eighty-eight patients with low grade non-Hodgkin's lymphoma were followed for a median period of 63 months. Sixty-eight per cent of the group were centrocytic/centroblastic B cell lymphomas by the updated Kiel classification. Fifty-one (58 per cent) of the patients were stage IV by the Ann Arbor classification. In 18 of these patients the bone marrow was the only site of extranodal involvement. Univariate survival analysis showed that the sum of involved sites was more discriminatory than Ann Arbor stage. Analysis by site of involvement showed that the liver and other intraabdominal sites were associated with worse survival than involvement of peripheral lymph nodes. Bone marrow and spleen involvement were not significantly associated with short survival. Increasing age at presentation was strongly associated with shorter survival and was also inversely correlated with serum albumin. Both low absolute lymphocyte count (< 1.0 x 10(9)/l), low serum IgG level (< 10 g/l) and low total immunoglobulins on presentation were significantly associated with short survival. Multivariate analysis showed that age, serum albumin and number of involved sites gave the best survival prediction. The sum of involved sites, immunoglobulin level and absolute lymphocyte count may be useful objective markers of prognosis in low-grade non-Hodgkin's lymphoma.

Serum immunoglobulin levels in patients with lymphoproliferative diseases in Erbil, Kurdistan region, Iraq

“…12 Low levels of one type or more of immunoglobulin were frequently found in this study. The suppression of immunoglobulin was mild, this finding has repeatedly been reported by other workers 13 and has been associated with advanced disease . This immunosuppression is related to decreased Ig production resulting from B-cell depletion due to the replacement of lymphoid tissue or due to the effect of treatment 14,15 or as a result of malnutrition.…”

Absolute lymphocyte count predicts overall survival in follicular lymphomas

“…However, they looked at a heterogenous histological group of NHL patients. Parker et al (1994) reported shortened survival in patients with an ALC <1 × 10 9 /l at diagnosis in a small heterogenous group of NHL patients, including follicular, mixed small and large cleaved and large cell, diffuse large cell, small lymphocytic lymphoma and mycosis fungoides. In contrast to the FLIPI study, where the ALC was not included in the top five prognostic factors used by the clinical committee of the FLIPI project in order to make its use easier in routine practice, our study differed as follows: (i) we included only grades 1 and 2 FLs, as grade 3 FLs tend to behave similarly to diffuse large cell lymphoma; and (ii) we identified that an ALC ≥ 1 × 10 9 /l was an independent prognostic factor regardless of whether the patient was initially observed or treated, whereas treatment was not included in the prognostic analysis of the FLIPI study.…”

A pooled analysis of three studies evaluating genetic variation in innate immunity genes and non‐Hodgkin lymphoma risk

“…IL1RN , along with IL1A and IL1B , make up the interleukin 1 ( IL1) gene family cluster on chromosome 2q. Specifically, IL1RN is known to alter IL1B expression levels (Santtila et al , 1998), leading to a modulation of a variety of IL1 ‐related immune and inflammatory responses, which may affect the risk of haematopoietic cancers (Parker et al , 1994; Bastion et al , 1997; Elahi et al , 2005). Further, variants in IL1 genes have been associated with susceptibility to and clearance of infectious agents (Witkin et al , 2002).…”