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Profile of B-cell Non-Hodgkin lymphoma and response to chemotherapeutic regimens in a tertiary care center in South India

Srilakshmi Kalidindi, C Deepak Yadlapalli, S. Sarma Yerraguntla, Muralidhar Gullipalli, Ganapathy Swamy Chintada.




Abstract
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Introduction: Non‐Hodgkin lymphoma’s (NHL) are a group of malignant lympho-proliferative disorders arising predominantly in lymph nodes with different patterns of behavior and responses to treatment. NHL clinical presentation varies with histology sub type and with sites of involvement. Accurate staging is important, which helps in risk stratification and management decisions.
Aim: Aim was to study the clinical profile of patients with B-cell NHL and to assess response to various chemotherapeutic agents.
Materials and methods: We evaluated data of patients diagnosed with B-cell NHL between 2015 and 2019 at a tertiary care cancer hospital in Andhra Pradesh, India. Data regarding demographic variables, clinical features and examination findings were collected using a pre-designed study proforma. Lab investigations including complete blood picture, liver and renal function tests, bone marrow examination, immunohistochemistry and treatment details were noted.
Results: A total of 91 patients with B-cell NHL were managed. Mean age was 53yrs,with males accounting for 60%. Mean duration of presentation was 4.32 months. Most common presentation was lymphadenopathy,followed by loss of appetite, weight loss, fever and night sweats.Majority of study subjects were diagnosed as Diffuse large B Cell Lymphoma 70 (76.9%), followed by Follicular lymphoma 10 (11.0%), Small lymphocytic lymphoma 7(7.7%). Bone marrow involved in 22 (24.2%); Stage IV accounted by 34 (37.4%) followed by Stage III. CHOP regimen of 6 cycles was received by 30 (33.0%) patients, out of which 23 patients had complete response; 61 (67.0%) patients received R-CHOP, out of which 58 had complete response.
Conclusion: B-cell NHL has an early onset in India compared to western literature. Accurate staging is important, which helps in risk stratification and management decisions. Treatment with R-CHOP is superior to CHOP regimen with better prognosis and survival. Monitoring at periodic intervals for possible relapse is important as many patients whose disease recurred can be salvageable.

Key words: B-cell Non Hodgkin Lymphoma, DLBCL, RCHOP






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