Prognostic factors in indolent and aggressive lymphomas and its influence on disease outcome

The aim of the study was to determine the prognostic significance of clinical, laboratory and immunological parameters in indolent and aggressive lymphomas, and to evaluate overall survival in different risk category patients. Based on our investigations patients' age, disease stage, number of extra nodal sites involved, patient performance status 2-4 by ECOG, strongly influenced overall survival in the indolent as well as in the aggressive lymphomas. In indolent lymphomas in case of less than three unfavorable prognostic factors patients overall survival was high (41.04 month) in comparison with patients with three or more unfavorable prognostic factors (14.2 month). Efficacy of treatment was studied in indolent lymphomas, which revealed that in case of one or two unfavorable prognostic factors treatment response is high (82-100%), in case of three factors possibility of remission decreases (56%), in regards to four or five unfavorable factors remission rate is the lowest (40%). Patients overall survival rates with diagnosis in aggressive T-cell and B-cell lymphomas were studied. Analysis of results showed that T-cell phenotype strongly influence the survival of patients with diagnosis of aggressive non-Hodgkin's lymphomas, patients' survival is lower in T-cell lymphomas 7.6 month compared with 17.3 month for B-cell lymphomas. In patients with diagnosis of stage III or IV aggressive lymphomas, three or more unfavorable prognostic factors and T-cell phenotype detects patient which are refractory to the standard chemotherapy schedules. In diffuse large B-cell lymphomas according to the CD10 expression (which was used as an unfavorable prognostic factor in high and high intermediate risk groups) and quantity of the unfavorable prognostic factors identified patients which were primary refractory to standard treatment regimens. In addition we could conclude that in indolent and aggressive lymphomas clinical, laboratory and immunological parameters could be used to identify patients which are primary refractory to standard therapies of treatment.