dlbcl cancer | Malignant lymphomas not hodgkiniens

Malignant lymphomas not hodgkiniens





Abstract
No hodgkiniens (LMNH) malignant lymphomas are malignant proliferations of the tissue lym-rum diagnosis is always the result of the examination of a tissue biopsy. This allows to distinguish them from the door Hodgkin. lymphoma usually on tumor ganglionic or extranodal superficial or deep. The different tumor locations will be searched in the assessment of the spread of the disease. Their classification was investigated in 2001, under the aegis of the who, d ' a consensus gathering the different classifications used in the world (1) and has therefore not been applied here.


Malignant lymphomas not hodgkiniens
Authors: PM Carli, A. Monnereau, R.O. Casasnovas, X. Troussard, N. Maarouf,.
Mr. Maynadie
Description of the study location
Definition in the different classifications:
ICD-O-2: location C00.0 to C80.9
Morphology: M9590 to M9595, M9670 to M9723; tumor behavior 3
ICD-O-1 correspondence: 140.0 to 199.9
Morphology: M9590 to M9642, M9690 to M9722; tumor behavior 3
Correspondence in ICD - 10: C82.0 to C85.9 and C96.0, C96.1 and C96.3 to C96.9
No hodgkiniens (LMNH) malignant lymphomas are malignant proliferations of lymphoid tissue
which the diagnosis is always the result of the examination of a tissue biopsy. This allows you to
distinguish them from Hodgkin's lymphoma. She usually wears on ganglionic tumor
or extranodal superficial or deep. The different tumor locations will be
searched in the assessment of the spread of the disease. Their classification was investigated in 2001, under
the aegis of the who, a consensus gathering the different classifications used previously
in the world (1) and has therefore not been applied here.
Frequency
The estimated number of new cases of LMNH was in France for the year 2000 to 9 908, including 56%
in men. The standardized population incidence rate was 13.3 in
human and 7.8 in women. In the same year, 5 243 certificates of death by Lymphoma
were recorded, is a standardized 5.3 in humans and 3.4 death rate at
the woman (2). As noted in tables 6 and 8 of the previous chapter, this analysis
has been performed on 6 375 cases, of which 3 383 had died within 5 years of diagnosis.
Raw survival and relative survival
Raw survival was equal to 71% at 1 year, 54% at 3 years and 46% in 5 years and the relative survival was respectively
74%, 61% and 55% (table 1). Figure 3 shows that for the whole of
ages excess mortality was much higher in the 6 months following diagnosis. He remained
roughly stable from the second year.
Variation by sex and age
Relative 5-year survival was slightly better in women (56%) than men
(54%) (table 1 and figure 1). This difference was more pronounced after standardization
(table 5) and also accented in the multivariate analysis with a relative rate of 0.83 for the
women to men (table 7).
Significant differences appeared depending on the age at diagnosis. The 5-year relative survival
was, indeed, 67% for the age group 15-44 years to 35% for those 75 years and older
(table 2 and figure 2). The age effect was not linear, the deterioration of the prognosis being more
fast after age 65 (table 8 and figure 5). Mortality added by the disease to distance from the
Results: Malignant lymphomas not hodgkiniens

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Survival of patients with cancer in France
diagnosis was significantly lower in younger patients (< 1% against approximately
10%; (Figure 3). This effect could be considered independent of the time elapsed since
diagnosis (proportionality test p = 0.058).
Variation according to the period
Survival increased slightly between the first and the last period. The 5-year relative survival
went from 53% for the period 1989 - 1991 to 57% for the period 1995-1997. This increase
was also observed in 3 years (table 3). The multivariate analysis confirmed this fact by identifying
a significant increase in the survival of 2% a year (table 7).
Variation by Department
There was significant variation of the surviving measured between the various departments
(table 8 and figure 4). The related survivors ranged from 47 to 64% for the whole of the departments
of the study.
Comparison with the EUROCARE study
Comparison of standardized rates on the age with the results of the EUROCARE study (1990 -
1994) for comparable periods showed that the survivors in our study were significantly
the same survival average in Europe, in humans: 47% vs. 48%, at the
woman: 58% vs 54% (tables 5 and 6) (3).
Comments
The survival of the LMNH is an intermediate for the period 1989-1997, without difference
notable between the France and the average of the other European countries. However the comparison with
the U.S. Caucasian population show better survival in the United States. Indeed, the
the SEER program for the period 1992-1999 results on survival figures
5 years standardised for age of 57% (54% in men and 61% in women) (4). In the
polpulation black on the other hand, the rate is 47% (42% men and 55% women).
It is interesting to note the improvement of the survivors that we observe between the beginning and the end of
the period which although small is statistically significant. This fact is probably due to the
therapeutic progress observed in these pathologies with the improvement of decision-making protocols
in charge who took place in this decade and that should grow again in the future with
the arrival of monoclonal antibodies (5).
Another element to take into account to analyse the LMNH survival is the heterogeneity of
classifications which have finally been grouped into a consensual classification which could not
have been used in the studies available, since survivors published end of 2001 under the auspices of
the who (1).

In France and Europe, close to 75% of the LMNH are phenotype B and two subtypes the
more common are follicular Lymphoma on the one hand and diffuse large cell lymphoma
on the other hand. Their support is not the same: for example, the first are treated by irradiation
associated to chemotherapy for limited stadiums, others are treated by chemotherapy
exclusive (6). In case of relapse, autografts of stem cells will be a support to chemotherapy
high dose. This difference in support is a factor that is not taken into
into account in this analysis and to show probably substantial differences. These therapies,
often aggressive, are not always being implemented in the elderly, as too toxic.
where the finding of a much lower survival for subjects over 75 years.
The phenotype LMNH T are mainly cutaneous localization with the Mycosis fungoide which is