title: The role of predictor factors in patients with non Hodgkin lymphoma in relation to the applied therapy.
abstract: Lymphoma are defined as malignant neoplasms of immune system, or in other words the neoplasms of lymphocytes and their precursory cells which form the basic cellular elements of the immune system. The heterogeneity of lymphoma from the aspect of morphology and the aspect of clinical manifestations demanded the identification of all possible parameters which could influence the course and outcome of the disease on every single level. The aim of our study was to investigate which of the prognostic factors confirms the statistical importance of the remission state and overall survival and if the patients treated with standard PHT (poly chemotherapy) protocols with the addition of anti-CD20 antibody show more clinical benefit.
  
  
  METHODS
  Considering the applied protocol, patients were divided in two groups: group of patients treated with PHT protocol CHOP (Cyclophosphamide, Adriamycin, Oncovin, Pronison) and the group treated with PHT protocol with the addition of anti-CD20 antibody (Rituximab).
  
  
  RESULTS
  There was no statistically significant difference in values of Karnofsky score between patients in CHOP and CHOP+R groups before the therapy (U=133; Z = -1.87; p = 0.06), although this difference was on the border of statistical significance. The values of Karnofsky score before and after the therapy in CHOP group showed no significant difference (Wilcoxon Z = -1.62; p = 0.11), but CHOP+R group pointed significant differences before and after the treatment, (Wilcoxon Z = -2.34; p = 0.02) with generally higher values after the therapy. Looking from the aspect of B-symptomatology in CHOP group, there was a significant reduction of B-symptoms (50%; %95 CI = 19-50; p = 0.002) after the therapy (7/20; 35%) in comparison with patients before the therapy (17/20; 85%). According to those results, the reduction of symptoms in CHOP +R group was more evident (60%; 95% CI = 28-60; p < 0.001) after the therapy (3/20; 15%) comparing to the state before the therapy (15/20; 75%). Comparison of LDH values in the complete sample demonstrated that the value of LDH before the therapy was significantly higher (Z = -3.76; p < 0.001). There was a significant difference in number of patients in relation to the category of IPI prognostic index (chi2 = 10.38; df=3; p < 0.02), pointing out most of the patients with low intermediary risk in CHOP+R group, and largest number of patients with high and high intermediary risk in CHOP group.
authors.affiliation: Clinic for Oncology, Hematology and Radiotherapy, Department of Hematology, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina. samira.hasic@ukc.ba
authors.forename: Samira
authors.initials: S
authors.lastname: Hasic
authors.forename: Aida
authors.initials: A
authors.lastname: Arnautovic
authors.forename: Svetlana
authors.initials: S
authors.lastname: Jovic
authors.forename: Alma
authors.initials: A
authors.lastname: Halilbasic
authors.forename: Emina
authors.initials: E
authors.lastname: Mazalovic
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D017567:Karnofsky Performance Status; D008228:Lymphoma, Non-Hodgkin / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012074:Remission Induction; D000069283:Rituximab; D055815:Young Adult
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000069283:Rituximab