Extranodal Non-Hodgkin Lymphomas: The Impact of Different Variables on the Disease

Abstract

Background: Extranodal non-Hodgkin lymphoma (ENL) occurs in 25-40% of non-Hodgkin lymphoma (NHL) patients. The objective of this study is to analyze the incidence, anatomical distribution, histopathological subtypes, prognostic factors, and the impact of the site on behavior and treatment response of extranodal lymphoma. Methods: In this retrospective analytical study, 84 out of 379 NHL patients diagnosed with ENL were included. The patients were treated via predominantly chemotherapy and/or field external beam radiotherapy. Results: The mean age of these 84 patients was 42.5 years (range 4-80 years). The leading site of ENL involvement was head and neck in 35 (41.66%) patients. Diffuse large B-cell lymphoma was the most common histological type in 46 (54.76%) patients. The median follow-up was 72.3 months (range 3.2-132.4 months). The CR was achieved in 40 patients (47.6%), PR was achieved in 22 (26.2%) patients, and NR was observed in 22 (26.2%) patients. Highest mean PFS, observed in GIT malignancies, was 68.4 months (54-82.8), overall mean progression-free survival (PFS) was 73.2 months (61.3-85.1) (P=0.369), and mean overall survival was 88.4 months (82-94.7) with a P-value of 0.014, which was statistically significant. Conclusion: Based on the results of this study, it is concluded that extranodal NHL accounts for almost 25% of all NHL. Hence, before the initiation of treatment, all the NHL cases should be properly investigated and staged. Extranodal NHL responded well to chemotherapy as NHL. Furthermore, it was observed that treatment with field external beam radiotherapy results in an increase in the levels of progression-free survival and overall survival.

Keywords

• Extranodal non-Hodgkin’s lymphoma (ENL)
• Chemotherapy
• Involved field radiotherapy
• Site of involvement
• Prognosis