Increase in the incidence of non-Hodgkin's lymphoma, clinical features and long-term follow-up (original) (raw)
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Increasing incidence of non-Hodgkin's lymphoma in Canada, 1970-1996: age-period-cohort analysis
Hematological Oncology, 2003
Previous studies have shown that the incidence of non-Hodgkin's lymphoma (NHL) has increased in many parts of the world in recent decades. Using data obtained from the Canadian Cancer Registry, the present study examined time trends in NHL incidence in Canada between 1970 and 1996 and the effects of age, period of diagnosis and birth cohort on incidence patterns for each sex separately. Results showed that overall age-adjusted incidence rates increased substantially, from 7.3 and 5.2 per 100 000 in 1970-1971 to 14.0 and 10.0 per 100 000 in 1995-1996 in males and females, respectively. Diffuse lymphoma was the major histological subtype, accounting for approximately 76% of NHL cases over the 27-year period. The data suggest that period effects have played a major role, although birth cohort effects may also have been involved. Sex-specific patterns of the incidence were similar over the time period of diagnosis but were distinct among recent birth cohorts. In conclusion, there is in fact a marked increase in NHL in Canada which cannot be explained in terms of improvements in diagnosis, changes in NHL classification and the increase in AIDS-associated NHL alone. The birth cohort effect in NHL suggests that changes in risk factors may have contributed to the observed increase.
A Clinico-Pathological and Prognostic Analysis of Non-Hodgkin Lymphoma: A study of 203 patients
Acta Oncologica, 1988
In a retrospective analysis of 203 patients with non-Hodgkin lymphoma (NHL) treated between 1975 and 1985, the relationship between pathology, clinical presentation and course, was studied, using the Kiel classification. This classification was a much better predictor of prognosis than clinical stage and within the different pathology groups there was no significant difference between the stages concerning the survival rate. In the group with low grade malignancy this latter was positively associated with nodular architecture, bone marrow involvement and complete or partial response to therapy. In the high grade group, the survival was positively correlated to complete remission, but no plateau was seen in the survival curve. All extranodal sites had poor survival. For both grades, age (>60 years), systemic symptoms and biologic signs (Ann Arbor 'B' and 'b') were unfavorable prognostic factors.
Lymphoma Incidence in a Swedish County During 1969–1987
Acta Oncologica, 1992
The incidence of lymphoid malignancies (acute leukemias and myelomatosis excluded) during [1969][1970][1971][1972][1973][1974][1975][1976][1977][1978][1979][1980][1981][1982][1983][1984][1985][1986][1987] in the County of Uppsala was calculated on the basis of the regional cancer register and local registers from the only oncological, hematological, dermatological and pathological departments in this well-defined geographical area. Of the 774 patients included, 639 had histopathological specimens available, all of which were reexamined. Seventy-nine patients were diagnosed on the basis of bone marrow investigations ( > 70% reexamined, all had a low-grade non-Hodgkin's lymphoma = NHL) and 54 on fineneedle aspiration biopsies (not re-examined). Seventy-nine of the lymphoma diagnoses were based on autopsy specimens. The overall age standardized incidence was 16.2/100 000/year (NHL: 13.6, Hodgkin's disease = HD: 1.5) according to the Swedish 1970 census (according to world standard population: 10.2); male: 20.9, (12.9) and female: 12.4 (7.9). The annual change in trend was +3.0% f 2.6 (NHL: +3.6% f 2.4, HD: no change). The omission of the 54 'fine needle cases' led to an overall incidence of 15.0 (9.7) and an annual change in trend of +3.5% f 1.9. Among the histopathological specimens, an NHL was found in 524 patients and HD in 69. In 46 registered patients, the diagnosis malignant lymphoma was wrong. The diagnosis changed to NHL in 43 patients registered as HD.
Epidemiology of Non-Hodgkin’s Lymphoma
Medical Sciences, 2021
Non-Hodgins’s lymphoma (NHL) is the most common hematological malignancy worldwide, accounting for nearly 3% of cancer diagnoses and deaths. NHL is the seventh most prevalent cancer and has the sixth highest mortality among cancers in the US. NHL accounts for 4% of US cancer diagnoses, and incidence has increased 168% since 1975 (while survival has improved 158%). NHL is more common among men, those >65 years old, and those with autoimmune disease or a family history of hematological malignancies. NHL is a heterogenous disease, with each subtype associated with different risk factors. Marginal zone lymphoma (MZL) is strongly associated with Sjogren’s syndrome (SS) and Hashimoto’s thyroiditis, while peripheral T-cell lymphoma (PTCL) is most associated with celiac disease. Occupational exposures among farm workers or painters increases the risk of most of the common subtypes. Prior radiation treatment, obesity, and smoking are most highly associated with diffuse large B-cell lympho...
Non-hodgkin's lymphomas iv. clinicopathologic correlation in 405 cases
Cancer, 1973
An analysis is presented of the histopathologic, clinical, and prognostic features in a series of 405 previously untreated patients with non-Hodgkin's lymphomas referred to Stanford University Medical Center between 1960 and 1971. .411 biopsies were histologically classified according to the criteria of Rappaport et al. and clinical extent of disease was thoroughly evaluated prior to treatment and staged according to the Ann Arbor Classification. Nodular lymphomas constituted 44% of the group and diffuse lymphomas 56%. Patients under the age of 35 years and those over 60 tended to have diffuse lymphomas. Although 39% of the patients had Stage I V disease at presentation, localized forms (Stage I, I,., 11, 11,) were observed in 37%. Localized extralymphatic involvement occurred more often in patients with diffuse than nodular lymphomas (11 < 0.001). Systemic symptoms occurred in 24% of patients with diffuse and 17% of those with nodular lymphomas; however, their presence did not adversely affect survival. Mediastinal adenopathy was noted in 24% of diffuse and 18% of nodular lymphomas (P = NS), and mediastinal "skipping" was observed in 20% of diffuse and 40% of nodular lymphomas ( p < 0.05). By the criteria used, 81% of evaluable patients (Stages I1 through 111,) with nodular lymphoma and 90% of those with diffuse lymphoma had contiguous sites of involvement ( p = 0.07). Two frequently observed sites of initial extralymphatic involvement were bone marrow and gastrointestinal; the former was observed more often in advanced lymphocytic lymphomas, whether nodular or diffuse, and the latter in advanced, diffuse lymphomas. Actuarial survival correlated strongly with the histopathologic type of lymphoma; in each cellular category, patients with nodular lymphomas survived significantly longer than those with diffuse lymphomas (1' < 0.05). Age at presentation also influenced survival in relation to certain histologic patterns. Patients with diffuse lymphocytic or mixed lymphomas who were less than 40 years of age had a worse prognosis than those over 40 (p = 0.02).
European Journal of Cancer, 2006
This population-based study investigates the use of chemotherapy and radiotherapy for non-Hodgkin&amp;amp;amp;amp;amp;amp;amp;#39;s lymphoma (NHL) treatment in clinical practise generally, and for specific histologies, and identifies factors associated with treatment and survival. Data for NHL patients, diagnosed during 1999-2001, were obtained from the National Cancer Registry (Ireland). Multivariate models were analysed on survival and treatment. 45-77% of patients received chemotherapy, 22-34% of patients received the radiotherapy, depending on the histology. Patients aged &amp;amp;amp;amp;amp;amp;amp;lt;65, married, with early stage B-cell aggressive disease were more likely to receive chemotherapy (P&amp;amp;amp;amp;amp;amp;amp;lt;0.05). Patients &amp;amp;amp;amp;amp;amp;amp;gt;65 or with advanced stage were less likely to receive radiation (P&amp;amp;amp;amp;amp;amp;amp;lt;0.05). Survival was poorer in older (P&amp;amp;amp;amp;amp;amp;amp;lt;0.001) and unmarried patients (P&amp;amp;amp;amp;amp;amp;amp;lt;0.05), and those with B-cell aggressive lymphoma (P&amp;amp;amp;amp;amp;amp;amp;lt;0.001). Patients who received chemotherapy and radiation had lower hazard ratios. Overall, the use of chemotherapy and radiation in this European population was similar to the findings in the US where older patients received treatment less often. However, the age disparity here was greater than that in the US.
Güneydoğu Anadolu Bölgesindeki Non-Hodgkin Lenfoma Sınıflaması: 550 Hastanın İncelenmesi
Harran Üniversitesi Tıp Fakültesi Dergisi, 2019
Background: The distribution of non-Hodgkin lymphoma (NHL) subtypes differs around the world. In this study we aimed to evaluate the gender, age, subtypes, biopsy sites, nodal and extranodal residential area, and stage of disease in the patients with NHL admitted to our hospital between January 2005 and December 2014.Materials and Methods: The records of NHL patients admitted to our hospital between January 2005 and December 2014 were retrospectively reviewed Results: Among 550 patients, 335 patients (60.9%) were male, 215 patients (39.1%) were female. The average age of over all the patients was 56 years (15-95). The average age of women was 57 (15-88), the average age of men was 54 years (15-95). The histological subtypes of NHL patients were as follows: 447 patients (81.3%) B-cell lymphoma, 84 patients (15.2%) T / NK cell lymphoma, 19 patients (3.5%) unclassified subtype. NHL patients divided into subtypes according to 2001 and 2008 WHO (World Health Organization) Classificatio...
How the Epidemiology of Hodgkin Lymphoma Changed in Debrecen, Hungary
Medical Research Archives, 2016
Introduction. Hodgkin lymphoma shows a well-known geographic pattern. Incidence also varies significantly by age, sex, ethnicity and socioeconomic status. These clinical pathological features of the disease are changing. Patients and methods. 715 Hodgkin lymphoma patients' clinicopathological and treatment data were assessed in a maximum of ten-year periods. The patients were treated at the University of Debrecen, Department of Hematology from 1980 until the end of 2014. Results. The first period (1980-89) contained 193, the second (1990-99) 199, the third (2000-09) 236 and the fourth (2010-14) 87 Hodgkin lymphoma patients. The mean age of the patients were 39, 34.5, 38 and 36.8 years respectively. The male/female ratio was 1.29, 1.23, 1.03 and 0.97 in order. A unimodal age group pattern can be seen in the first and second periods with an incidence peak between 20 and 29 years of age. Bimodal age group pattern was observed in the third and fourth periods with the first incidence peak between 20 and 29 years of age and the second between 50 and 59 years. The incidence of classical mixed cellularity (cMC) histological subtype is decreasing (38%, 49%, 48% and 26%; p < 0.01) while classical nodular sclerosis (cNS) shows an increasing tendency (21%, 28%, 30% and 50%; p < 0.01). The first peak is predominantly caused by the cNS subtype in the third and fourth period, and the second peak caused by cMC subtype in the third and cNS in the fourth period. The number of advanced stage patients (59%) is beyond the early stage patients (41%) in the last observed period. The 5-year overall survival is increasing (64.2%, 84.6%, 87% and 92%). Discussion. The changing patterns can be explained by the altered nature of the disease, changes in immunological features, environmental factors, socioeconomic status and development of diagnostic and therapy methods.
Non-hodgkin's lymphoma.A study of the evolution of the disease based upon 92 autopsied cases
Cancer, 1979
The evolution of the disease process in 92 patients with non-Hodgkin's lymphoma has been analyzed by comparing the initial histopathologic material with that obtained at autopsy. The distribution of lymphoma did nat differ substantially among the subtypes, but the gross appearance of the lesions was different among certain subtypes, particularly between the "small cell" and "large cell" types. The diffuse lymphomas showed a remarkable constancy of subtype in the same patient, whereas the nodular lymphomas showed a high frequency of change to a diffuse pattern and/or a larger cell type. Diffuse histiocytic lymphomas with plasmacytoid features showed a striking propensity for involvement of the gastrointestinal tract. The Occurrence and significance of bizarre pleomorphic giant cells, epithelioid histiocytes, a "starry-sky" pattern, erythrophagocytosis, hemosiderosis and extramedullary hematopoiesis are reported. All patients received anti-lymphomatous chemotherapy and/or radiotherapy. A second malignancy was observed in 8 patients. Thirteen patients showed no residual lymphoma at autopsy. The cause of death was considered to be related to lymphoma in all 92 patients; 67 had infections identified. Cancer 44:529-542, 1979. HE EXTENSIVE pretreatment evaluation of T large numbers of patients with non-Hodgkin's lymphomas has substantially increased our knowledge of these diseases.8*16 Previous reports have confirmed the usefulness of the classification of Rappaport by demonstrating correlations between histologic subtype and age, stage and p r o g n~s i s. '~~'~ The architectural pattern and cytologic type have usually been constant in multiple biopsies from the same patient.20 Whereas early reports often referred to a u t o p~i e s , '~~~~~~~ most recent reports have focused upon the initial biopsy material and have not considered changes in architectural pattern and/or cell type as a function of time and treatment. This
Biological and clinical features of non-Hodgkin's lymphoma in the elderly
Journal of B.U.ON. : official journal of the Balkan Union of Oncology
The incidence of non-Hodgkin's lymphomas (NHLs) in elderly people has increased in recent years because the world population is getting older. The aim of this study was to compare the biological and clinical features in patients diagnosed with NHLs younger and older than 65 years, and the possible influence of age on the choice of optimal therapeutic approach. We retrospectively evaluated 193 patients with NHLs: 111 (68%) were <65 years and 82 (42%) ≥65 years. The following parameters were analysed: age, gender, clinical stage, International Prognostic Index (IPI), histological type, presence of B symptoms, disease localization, presence of bulky mass, Karnofsky performance status (PS), comorbidities, blood counts, liver and renal function and serum LDH. Elderly patients had statistically more frequent indolent NHLs (p=0.036), IPI 3 and 4 (p<0.0001), presence of comorbidities (p<0.001), and less frequent presence of bulky disease (p7equals;0.043). Response to therapy wa...