Lymphoma
Hodgkin’s Disease and the Non-Hodgkin’s Lymphomas
by Dr. Tran-der Tan
Malignant lymphoma patients rank #10 in numbers in our cancer center and they accounted for 3.2% of all lymphoma patients nationwide (2011).
There are two types of malignant lymphomas – Hodgkin’s disease (HD) and non-Hodgkin’s lymphomas (NHLs) with differences in the epidemiology, pathology, orderly anatomic progression of nodal involvement, response to therapy, and outcome. Disease staging, tumor size, clinical symptoms, and patient’s general health must all be taken into consideration for treatment decisions. Combination chemotherapy is most often the main modality to treat malignant lymphomas, but for tumors confined locally or at certain sites, radiation therapy can be considered, too. Radiotherapy offers local treatment stabilization and is usually applied after the chemotherapy has achieved tumor shrinkage.
Literature review has revealed many advances in the treatment of malignant lymphomas, both in chemo and radiation therapies, especially in the target therapy for the diffuse extra lymphatic involvement type, or the high dose chemotherapy for the fast progressing Burkitt’s lymphoma, or in the stem cell bone marrow transplantation, all of which have contributed to a 50+% of overall disease-free survival.
Our results
We did a retrospective study on our patients with new HD or NHLs that were initially diagnosed and treated in our hospital between 1990 and 2011 to assess the 5-year survival (Table 1)
Total patients: 1,021 M: 527 (51.6%) F: 494 ( 48.4%) Median age:53 (age 2-100)
Survival rates of lymphoma by stage (1990-2011)
|
Stage |
I |
II |
III |
IV |
Unclear |
Total |
|
# of patients |
180 |
220 |
177 |
231 |
213 |
1,021 |
|
% of patients |
17.6% |
21.6% |
17.3% |
22.6% |
20.9% |
|
|
5-year survival |
84.5% |
78.2% |
58.6% |
54.6% |
|
67.2% |
|
10-year survival |
76.4% |
69.1% |
51.0% |
46.4% |
|
59.8% |
Survival by epidemiology type
We observed a 5-year overall survival rate of 89.2% for HD, 62.7% for the B-cell NHLs, and 45.8% for T-cell NHLs (Fig. 2）
HD: 75 (10.8%) B-cell NHLs : 459 (66.1) T-cell NHLs : 64 (9.2%)
Others: 96 (13.9%)
Survival rates of B-cell NHLs by pathological pattern
Extranodal MALT（Mucosa-Associated Lymphoma) :35（7.7%)
SLL/CLL(Small Lymphocytic Lymphoma/ Chronic Lymphocytic Leukemia):5（1.1%）
FL（Follicular Lymphoma) : 89（19.5%）
DLBCL（Diffuse Large B Cell Lymphoma）: 290（63.6%）
MCL（Mantel Cell Lymphoma）: 20（4.4%）
Burkitt: 17（3.7%）
Survival rates of B-cell NHLs by pathological pattern (Table 2) (Fig. 3)
Comparison with the US data
The data from the Surveillance Epidemiology and End Results(SEER) of the 5-year overall survival for malignant lymphomas for the same period (1999 to 2005) showed a 68.0% survival rate for male patients and 72.1% for female, while ours showed 60.8% and 67.6%, respectively (Table 3)
