ABCL-264 Insights Into the Treatment of Nodal Non-Hodgkin Lymphomas in a Low- to Middle-Income Country: A Unicentric Experience

Abstract

Non-Hodgkin lymphomas (NHL) are one of the most diagnosed forms of lymphoproliferative diseases, of which diffuse large B-cell lymphoma is the most common form. According to the literature, NHL with primary involvement of the lymph nodes occurs in 52%-70% of patients, being the most common primary localization in NHL. Treatment opportunities for NHL have become increasingly heterogeneous, but the penetrability of many of them, especially targeted treatments, is low in low- to middle-income countries (LMICs). The aim of this study was to evaluate the therapeutic implication of the use of the targeted approach in combination with conventional chemotherapy in the treatment of nodal-onset NHL. A retrospective study was performed, including 82 patients diagnosed with NHL and monitored at the Oncological Institute of the Republic of Moldova. Eighty-two patients participated in the study, 39 of whom were men and 43 were women. The mean age of the patients was 56.02±13.8 years. NHL had its onset in the peripheral lymph nodes in 84.14% of patients, the mediastinal lymph nodes in 8.53%, and the abdominals in 7.31%. The majority of patients were diagnosed in generalized stages: 18 (21.95%) in stage III and 43 (52.43%) in stage IV. Localized stages were found in 25.6% of cases, with 7 (8.53%) stage I and 14 (17.07%) stage II cases. Aggressive NHLs were diagnosed in 53 (64.63%) patients, whereas indolent NHLs were diagnosed in 29 (35.36%) cases. Sixty-two (75.6%) patients received, as first-line therapy, the combination of rituximab+chemotherapy (subgroup 1; Sg1), and 20 (24.39%) patients received just conventional chemotherapy (subgroup 2; Sg2). The overall response rate (ORR) in Sg1 was 87.09% and 65.0% in Sg2. Complete remissions (CR) were achieved in 64.51% of patients in Sg1 and 45.0% of cases in Sg2. Progression-free survival (PFS) had a median of 20 months in Sg1 and 12 months in Sg2 (P=0.001) Conclusions: The use of targeted treatment with rituximab increased the ORR rate (87.09% vs. 65.0%), the frequency of CR (64.51% vs. 45.0%), and PFS (20 months vs. 12 months [P<0.05]).