Autoimmune cytopenias in patients with malignant lymphoma: A multicenter report by the Polish Lymphoma Research Group.

IF 2.1 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL

Advances in Clinical and Experimental Medicine Pub Date : 2024-10-01 DOI:10.17219/acem/174502

Magdalena Witkowska, Joanna Drozd-Sokołowska, Anna Waszczuk-Gajda, Agnieszka Giza, Barbara Lewicka, Joanna Zdziarska, Damian Mikulski, Piotr Smolewski

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引用次数: 0

Abstract

Background: Autoimmune cytopenias (ACs), including immune thrombocytopenia (ITP), autoimmune hemolytic anemia (AIHA) and autoimmune granulocytopenia, are rare complications observed in lymphoma patients. They may appear before, during or after lymphoma diagnosis, whether the patients had disease progression or not.

Objectives: This study aims to correlate ACs with lymphoma type, disease course and prognosis. We performed a multicenter retrospective analysis of adult patients with malignant lymphoma and ACs coexistence diagnosed and treated in centers aligned with the Polish Lymphoma Research Group (PLRG).

Material and methods: The analysis covers the years 2016-2022 and included 51 patients comprised of 23 women and 28 men. Of these, 35 patients were diagnosed with AIHA, 15 patients with ITP and 1 patient with both AIHA and ITP.

Results: The most common type of lymphoma was Hodgkin lymphoma (HL) (12 patients) and diffuse large B-cell lymphoma (DLBCL) (14 patients). At the time of diagnosis, 31 (61%) of patients had stage 4 of HL or DLBCL, according to Ann Arbor classification. In total, the response to treatment was evaluated in 50 patients, with 25 being in complete remission and 6 in partial remission. We observed that B cell symptoms (p = 0.036), bone marrow involvement (p = 0.073), splenomegaly (p = 0.025), and more than 2 lines of treatment were more common in AIHA compared to ITP patients. Conversely, eucopenia (p = 0.056) and ACs without lymphoma progression (p = 0.002) were more often diagnosed in ITP patients.

Conclusions: In the study group, relapsed and refractory disease was observed more often, and shorter overall survival (OS) was noted in patients with DLBCL. We found that AC is associated with a worse prognosis in comparison to the general population of lymphoma patients. There were no differences in response to AC therapy. To have more accurate data, a larger group, as part of a multicenter study, should be evaluated.

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恶性淋巴瘤患者的自身免疫性细胞减少:波兰淋巴瘤研究小组的一份多中心报告

背景:自身免疫性细胞减少症(ACs)，包括免疫性血小板减少症(ITP)、自身免疫性溶血性贫血(AIHA)和自身免疫性粒细胞减少症，是淋巴瘤患者罕见的并发症。它们可能出现在淋巴瘤诊断之前，期间或之后，无论患者是否有疾病进展。目的:探讨ACs与淋巴瘤类型、病程及预后的关系。我们对在波兰淋巴瘤研究小组(PLRG)联合中心诊断和治疗的恶性淋巴瘤和ACs共存的成年患者进行了多中心回顾性分析。材料和方法:分析涵盖2016-2022年，包括51例患者，其中23例女性和28例男性。其中，35例患者诊断为AIHA, 15例患者诊断为ITP, 1例患者诊断为AIHA和ITP。结果:最常见的淋巴瘤类型为霍奇金淋巴瘤(HL)(12例)和弥漫性大b细胞淋巴瘤(DLBCL)(14例)。根据Ann Arbor分类，在诊断时，31例(61%)患者为4期HL或DLBCL。总共评估了50例患者的治疗反应，其中25例完全缓解，6例部分缓解。我们观察到，与ITP患者相比，AIHA患者中B细胞症状(p = 0.036)、骨髓受累(p = 0.073)、脾肿大(p = 0.025)和超过2种治疗方法更常见。相反，白细胞减少(p = 0.056)和无淋巴瘤进展的ACs (p = 0.002)在ITP患者中更常被诊断出来。结论:在研究组中，复发和难治性疾病更常见，DLBCL患者的总生存期(OS)更短。我们发现，与一般淋巴瘤患者相比，AC与较差的预后相关。对AC治疗的反应没有差异。为了获得更准确的数据，作为多中心研究的一部分，应该对更大的群体进行评估。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Advances in Clinical and Experimental Medicine MEDICINE, RESEARCH & EXPERIMENTAL-

CiteScore

3.70

自引率

4.80%

发文量

153

审稿时长

6-12 weeks

期刊介绍： Advances in Clinical and Experimental Medicine has been published by the Wroclaw Medical University since 1992. Establishing the medical journal was the idea of Prof. Bogumił Halawa, Chair of the Department of Cardiology, and was fully supported by the Rector of Wroclaw Medical University, Prof. Zbigniew Knapik. Prof. Halawa was also the first editor-in-chief, between 1992-1997. The journal, then entitled "Postępy Medycyny Klinicznej i Doświadczalnej", appeared quarterly. Prof. Leszek Paradowski was editor-in-chief from 1997-1999. In 1998 he initiated alterations in the profile and cover design of the journal which were accepted by the Editorial Board. The title was changed to Advances in Clinical and Experimental Medicine. Articles in English were welcomed. A number of outstanding representatives of medical science from Poland and abroad were invited to participate in the newly established International Editorial Staff. Prof. Antonina Harłozińska-Szmyrka was editor-in-chief in years 2000-2005, in years 2006-2007 once again prof. Leszek Paradowski and prof. Maria Podolak-Dawidziak was editor-in-chief in years 2008-2016. Since 2017 the editor-in chief is prof. Maciej Bagłaj. Since July 2005, original papers have been published only in English. Case reports are no longer accepted. The manuscripts are reviewed by two independent reviewers and a statistical reviewer, and English texts are proofread by a native speaker. The journal has been indexed in several databases: Scopus, Ulrich’sTM International Periodicals Directory, Index Copernicus and since 2007 in Thomson Reuters databases: Science Citation Index Expanded i Journal Citation Reports/Science Edition. In 2010 the journal obtained Impact Factor which is now 1.179 pts. Articles published in the journal are worth 15 points among Polish journals according to the Polish Committee for Scientific Research and 169.43 points according to the Index Copernicus. Since November 7, 2012, Advances in Clinical and Experimental Medicine has been indexed and included in National Library of Medicine’s MEDLINE database. English abstracts printed in the journal are included and searchable using PubMed http://www.ncbi.nlm.nih.gov/pubmed.