IBCL-380: Clinical Features of Non-Hodgkin Lymphomas with Primary Involvement of Peripheral Lymph Nodes in an Elderly Population

Abstract

Context: Non-Hodgkin lymphoma (NHL) is one of the most common types of cancer. It can be diagnosed at any age; however, it is more frequently diagnosed among elderly patients. Usually, age over 60 years is associated with an unfavorable prognosis mainly due to multiple comorbidities and poor performance status. More frequently, the onset of NHL starts with the primary involvement of the lymph nodes (LN) in 52–70% of cases. An important role in NHL prognosis, in addition to the immunohistochemical and molecular features, is played by the primary site of involvement. Objective: The study aims to emphasize the clinical aspects of NHL with primary LN involvement in patients over 60 years of age. Materials and Methods: A retrospective study was conducted on 78 patients with NHL with primary LN involvement aged from 60 to 84 years, examining the clinical features and the evolution of each case. Results: It was found that NHL with onset in the LN had developed more frequently in people aged between 60 to 70 years (73.1%). NHL more often developed primarily in the peripheral LN (84.7%) and less frequently in the mediastinal LN (6.4%) and abdominal LN (8.9%). Aggressive NHL predominated (59.0%), but indolent NHL in 41.0% was seen more frequently in cases of affection to the cervical LN (47.4%), inguinal LN (41.7%), and abdominal LN (42.9%). In most of the cases (73.8%), the tumor process spread to the regional LN. Extranodal metastases occurred more frequently in the liver (47.7%), bone marrow (BM) (43.2%), and spleen (29.5%). BM involvement was found predominantly in indolent NHL (53.1%). In aggressive NHL, BM metastases were identified in only 4.3% of cases. The 5-year OS of patients of the study group was low at 31.2%. Conclusions: NHL with primary LN involvement developed more frequently in people aged 60–70 years. The onset of NHL occurred more often in the peripheral LN (84.7%) and less frequently in the mediastinum (6.4%) and abdominal LN(8.9%). The ratio of aggressive NHLs to indolent NHLs was 59% vs. 41%. Extranodal metastases affect mainly the liver(47.7%), bone marrow (43.2%), and spleen(29.5%). BM involvement occurred more frequently in indolent NHL(53.1%). Five-year OS in the study group was reduced (31%), being influenced by comorbidities. Non-Hodgkin lymphoma (NHL) is one of the most common types of cancer. It can be diagnosed at any age; however, it is more frequently diagnosed among elderly patients. Usually, age over 60 years is associated with an unfavorable prognosis mainly due to multiple comorbidities and poor performance status. More frequently, the onset of NHL starts with the primary involvement of the lymph nodes (LN) in 52–70% of cases. An important role in NHL prognosis, in addition to the immunohistochemical and molecular features, is played by the primary site of involvement. The study aims to emphasize the clinical aspects of NHL with primary LN involvement in patients over 60 years of age. A retrospective study was conducted on 78 patients with NHL with primary LN involvement aged from 60 to 84 years, examining the clinical features and the evolution of each case. It was found that NHL with onset in the LN had developed more frequently in people aged between 60 to 70 years (73.1%). NHL more often developed primarily in the peripheral LN (84.7%) and less frequently in the mediastinal LN (6.4%) and abdominal LN (8.9%). Aggressive NHL predominated (59.0%), but indolent NHL in 41.0% was seen more frequently in cases of affection to the cervical LN (47.4%), inguinal LN (41.7%), and abdominal LN (42.9%). In most of the cases (73.8%), the tumor process spread to the regional LN. Extranodal metastases occurred more frequently in the liver (47.7%), bone marrow (BM) (43.2%), and spleen (29.5%). BM involvement was found predominantly in indolent NHL (53.1%). In aggressive NHL, BM metastases were identified in only 4.3% of cases. The 5-year OS of patients of the study group was low at 31.2%. NHL with primary LN involvement developed more frequently in people aged 60–70 years. The onset of NHL occurred more often in the peripheral LN (84.7%) and less frequently in the mediastinum (6.4%) and abdominal LN(8.9%). The ratio of aggressive NHLs to indolent NHLs was 59% vs. 41%. Extranodal metastases affect mainly the liver(47.7%), bone marrow (43.2%), and spleen(29.5%). BM involvement occurred more frequently in indolent NHL(53.1%). Five-year OS in the study group was reduced (31%), being influenced by comorbidities.