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Vojnosanitetski pregled
2015, vol. 72, br. 1, str. 26-32
jezik rada: engleski
vrsta rada: izvorni naučni članak
objavljeno: 09/01/2015
doi: 10.2298/VSP1501026A
Bolesnici sa folikularnim limfomom, visokim FLIPI skorom i velikom tumorskom masom - model za određivanje rizika
aKlinički centar Srbije, Klinika za hematologiju, Beograd
bKlinički centar Srbije, Klinika za hematologiju, Beograd + Univerzitet u Beogradu, Medicinski fakultet

e-adresa: boleoli@sezampro.rs

Sažetak

Uvod/Cilj. Široko prihvaćeni internacionalni prognozni indeks za folikularni limfom (FLIPI) svrstava bolesnike u tri grupe rizika na osnovu skora nepovoljnih prognoznih faktora. Procenjeno 5-ogodišnje preživljavanje bolesnika sa visokim FLIPI skorom je oko 50%. Cilj ove studije bio je analiza prognostičke vrednosti kliničkih i laboratorijskih parametara koji nisu uključeni u FLIPI i FLIPI2 indekse, kod bolesnika sa visokim FLIPI skorom i velikom tumorskom masom. Metode. Ova retrospektivna analiza obuhvatila je 57 novodijagnostikovanih bolesnika. Svi bolesnici dijagnostikovani su i lečeni u periodu između aprila 2000. i juna 2007. godine na Klinici za hematologiju Kliničkog centra Srbije, Beograd. Rezultati. Značajno lošije preživljavanje imali su bolesnici sa histološkim gradusom > 1 (p = 0,015), sedimentacijom eritrocita (SE) Ç 45 mm/h (p = 0,001) i hipoalbuminemijom (p = 0,008), dok je tendencija lošijeg preživljavanja postojala kod bolesnika sa Eastern Cooperative Oncology Group (ECOG) > 1 (p = 0,075). Multivarijantnom Cox regresionom analizom identifikovani su histološki gradus > 1, SE Ç 45 mm/h i hipoalbuminemija kao nezavisni prognostički faktori za nepovoljan ishod. Na osnovu kumulativnog skora nepovoljnih prognostičkih faktora, bolesnici koji su imali 0 ili 1 nepovoljan prognosticki faktor imali su značajno bolje petogodišnje ukupno preživljavanje u poređenju sa bolesnicima sa 2 ili 3 faktora rizika (75% vs 24,1%, p = 0,000). Zaključak. Rezultati našeg ispitivanja pokazuju da od testiranih prognostičkih parametara histološki gradus > 1, SE Ç 45 mm/h i hipoalbuminemija mogu doprineti izboru bolesnika koji zahtevaju inicijalno agresivniji modalitet lečenja, ukoliko su na prezentaciji prisutna dva ili tri od ovih parametara.

Ključne reči

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