Clinical Features And Prognostic Analysis Of 53 Cases Of Non-hodgkin’s Lymphoma Bone Marrow Involvement

Objective:To explore clinical characteristics and prognostic factors in non-hodgkin’s lymphoma(NHL)patients with bone marrow involvement(BMI)in our hospital.Methods:A retrospective analysis was performed to analyze the clinical data of 53 non-hodgkin’s lymphoma patients with bone marrow involvement in the first hospital affiliated to Fujian Medical University from December 2012 to January 2018.Demographic and clinical characteristics,laboratory indicators,immunological typing,flow cytology were recorded and analyzed by univariate and multivariate process.Results:1.Among the 53 cases of non-hodgkin’s lymphoma with bone marrow involvement,including 33 males and 20 females,with a male-to-female ratio of 1.65: 1,the average age of the whole group was 58 years old(ranged 20~82 years old),among which 27 cases(50.94%)were 60 years old or lower and 26 cases(49.06%)were more than 60 years old.There were 36 patients(67.92%)with B symptom and 19 cases(30.08%)without.25 cases(47.17%)of them beginning common pathogenic site of these patients in the study were lymph node and 28 cases(52.83%)were site outside of lymph node,which has a high risk for bone,spleen and gastrointestinal tract involvement.According to the Eastern Cooperative Oncology Group Performance Status(ECOG PS),the score of 0 and 1 accounting for 43.40%,while 2~4 score accounting for 56.60%.According to the International Prognostic Index(IPI),there were 1.89% of low-risk group,11.32% of medium-low risk group,32.07% of medium-high risk group and 54.72% of high risk group.Among the patients with bone marrow involvement,there were 39 cases of B cell non-hodgkin lymphoma,7 cases of T cell and NK/T cell non-hodgkin lymphoma.Diffuse large B cell lymphoma was the most common pathological type,the second was mantle cell lymphoma.2.Among the 46 patients with primary diagnosis of non-hodgkin’s lymphoma BMI,the average OS was 23.79 months.Univariate analysis revealed that the factors impacting the prognosis were age,whether B symptoms,treatment options,IPI,ECOG PS,Lymphocyte rate(LR),Monocyte rate(MR),and Lymphocyte-to-monocyte ratio(LMR).Multivariate analysis suggested that the period of treatment and LMR were the independent prognostic factors for OS.Conclusion:1.Among the untreated male non-hodgkin’s lymphoma patients with BMI,the morbidity was higher than that of women.There was no significant difference of morbidity between nodal and extranodal lymphoma with BMI.BMI was seen in 16.26% of patients with non-hodgkin’s lymphoma.Among BMI patients,Diffuse large B cell lymphoma was the most common pathological type,the second was mantle cell lymphoma.2.The factors impacting the prognosis were age,whether B symptoms,treatment options,IPI,ECOG PS,LR,MR,and LMR.The period of treatment and LMR were the independent prognostic factors for OS.