Prognostic Analysis of Patients with Primary Extranodal Lymphoma: A Retrospective Study

Abstract

Background

Originating from extranodal organs or tissues, primary extranodal lymphoma (PENL) acts in different primary sites with diverse clinical performances and PENL has remarkable geographical differences and lacks the relevant reports in each region.

Patients and Methods

Two hundred and twenty PENL patients were enrolled, and the relevant clinical and laboratory indicators were analyzed. In addition, statistical methods were applied to analyze the effects of different factors on overall survival (OS) and progression-free survival (PFS) of patients.

Results

The three most frequent primary sites of PENL are the digestive system, head and neck, and central nervous system. The patients were classified into groups based on their risk status, resulting in low-risk, medium-low-risk, medium-high-risk, and high-risk, and their respective 3-year OS values were calculated, which showed that 121 patients (55%) were in the low-risk group and 3-year OS was 85.2% (25.9% medium-low-risk, 3-year OS 66.6%; 15% medium-high-risk, 3-year OS 61.9%; 4.09% high risk, 3-year OS 45.7%). A multivariate analysis of the Cox regression demonstrated that serum beta 2-microglobulin (β₂-MG) and lactate dehydrogenase (LDH) were independent prognostic factors for OS and PFS, respectively. Both the performance status and pathological subtypes were independent prognostic factors for OS and PFS.

Conclusion

The correlated independent risk factors such as β₂-MG, LDH, performance status, and pathological subtypes, were helpful for effectively determining the prognosis of PENL patients and guiding treatment.

Keywords:

• beta 2-microglobulin
• lactate dehydrogenase
• performance status
• pathological subtype
• primary extranodal lymphoma
• prognostic analysis

Acknowledgments

We acknowledge all the patients who were included in the study. Doctor Xuguang Song, Cai Sun, Dongmei Yan, and Wei Sang of the Department of Hematology, the Affiliated Hospital of Xuzhou Medical University were thanked for their guidance and support during the research. This study was supported by the National Natural Science Foundation of China (grant nos. 81600145, 81700199, 81800159 and 81900179); the Natural Science Foundation of Jiangsu Province (grant no. BK20160232); China Postdoctoral Science foundation funded project (grant no. 2016M590508); the Foundation of Jiangsu Province Six Talents Peak (grant no. 2015-WSW-058); the Foundation of Jiangsu Province Six-one Project (grant no. LGY2018084); and Jiangsu Province Postgraduate Practice Innovation Program (grant no. SJCX19_0936).

Ethnics Statement

Written informed consent was obtained from the patients. This research was approved by the Ethics Committee at the affiliated hospital of Xuzhou Medical University and was conducted according to the guidelines put forth in the Declaration of Helsinki.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.