Büyük B Hücreli Lenfoma Hastalarına Ait Ara Değerlendirmede Yapılan Klinik, Laboratuvar ve Görüntüleme Sonuçlarının Retrospektif Olarak İncelenmesi

Abstract

Bayram A. İ. Retrospective Analysis of Clinical, Laboratory, and Imaging Findings in Interim Evaluation of Patients with Diffuse Large B-Cell Lymphoma; Hacettepe University Faculty of Medicine Department of Internal Medicine, Specialty Thesis; Ankara, 2025, Diffuse large B-cell lymphoma (DLBCL) is one of the most common types of lymphoma, and is typically characterized as a rapidly progressing cancer. Diagnosis involves clinical evaluation, laboratory parameters, imaging methods, and biopsy. Various prognostic indices incorporating these factors have been developed to predict the disease course at the time of diagnosis. However, different opinions exist in the literature regarding the prediction of survival and prognosis in DLBCL. The aim of our study was to retrospectively evaluate DLBCL patients by analyzing pre-treatment, interim assessment, and post-treatment parameters, and their effects on overall survival (OS) and progression-free survival (PFS). A total of 180 patients were included in the study. Parameters such as age, comorbidities, gender, lactate dehydrogenase (LDH) levels, B symptoms, pathological features, chemotherapy regimens, prognostic indices, extranodal involvement sites, pre-treatment positron emission tomography (PET) findings, interim PET parameters, and post-treatment PET parameters were analyzed. First-line treatment outcomes revealed that 78.9% (142) of patients were in remission, while 21.1% (38) had active disease. During follow-up, 30.6% (55) of the patients experienced progression and/or relapse, and 12.2% (22) were identified as having refractory disease. Additionally, 18.9% (34) of the patients died due to disease-related causes. When analyzed based on the presence of progression, significant associations were observed with non-germinal center-derived lymphoma, bone marrow involvement, liver involvement, International Prognostic Index (IPI), National Comprehensive Cancer Network-International Prognostic Index (NCCN-IPI), Age-Adjusted International Prognostic Index (AA-IPI), as well as baseline, interim, and post-treatment PET parameters. Furthermore, when the predictive power of these parameters for progression and survival was tested, certain statistically significant results were identified, suggesting their potential inclusion in future international prognostic indices. These findings have been presented to contribute to the existing literature. Keywords: Diffuse Large B-Cell Lymphoma, Prognosis, Overall Survival