Relationship Between Possible Indicators Of Disease Severity And Treatment Outcomes In Hodgkin Lymphoma
Keywords:
survival, absolute neutrophil count, treatment outcome, prognosis, lymphoma, HodgkinAbstract
Aims and objectives: To assess the relationship between some possible indicators of disease severity and the treatment outcomes in Hodgkin lymphoma.
Materials and Methods: This was a prospective study of patients histologically diagnosed with Hodgkin lymphoma from July 2016 to July 2019 in three tertiary hospitals in Nigeria.
Results: The patients included 20 males and 20 females, aged 17 to 76 years. Median values at diagnosis were; haemoglobin concentration (Hb) varied from 9.5g/dL (range 10, 95% CI), leucocyte count was 7.5 x 10 9 /L (range 32.2, 95% CI), absolute neutrophil count (ANC) was 4.3x 10 9 /L (Range 29.4, CI 95%), platelet count was 238 x 109/L (Range 474, CI 95%). Two (5.4%) patients were positive for HIV. Splenomegaly was seen in (8/33) 24.2 % of the patients at diagnosis. Neither age nor spleen size were noted to be associated with survival (r = -0.146; p= 0.474 and r =0.043; 0.967, respectively). Nodular sclerosis HL was the most prevalent (50%), with higher mortality (p=0.001). The mean absolute neutrophil count (ANC) at diagnosis was 4.3±7.8 x 109/L and was related to an increased risk of death (F = 585.9; p = 0.002). The mean haemoglobin concentration at diagnosis was 9.5 ± 2.5 g/dL and this had a direct relationship with the duration of survival (r = 0.637; p = 0.011). Twenty patients (57.1%) had AnnArbor Stage IV disease, while 5 (12.5%) had B symptoms. The relationship between ANC and duration of follow-up was not significant. Combination chemotherapy - ABVD, was used in 75% of the patients out of which 20% relapsed or failed treatment. High serum conjugated bilirubin and alkaline phosphatase were associated with poorer outcomes (r = -0.593; p=0.018 and r = -0.753; 0.019, respectively).
Conclusion: At presentation, haemoglobin concentration had a direct relationship with the duration of survival, while a high absolute neutrophil count and the nodular sclerosis HL subtype were associated with higher risk of death. There is, therefore, a need for more studies to corroborate these findings in larger patient groups.
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