Analysis of Factors Contributing to International Prognostic Index and Correla on Between High International Prognostic Index (IPI) and symptom duration in Lymphoma Patients

Shrestha R***, Gautam D*** Lakhey MR*, Paudel BP**

Abstract


Introduction: There are sparse publications in Non-Hodgkin’s Lymphoma in Nepal. Risk profile as per International Prognostic Index at the time of presentation is largely unknown. Often diagnosis is delayed for various reasons which may impact the risk profile which is not present in published studies. This study was undertaken to address these issues.

Method: Newly diagnosed Non-Hodgkin’s Lymphoma from May, 2016 presenting in Bir Hospital were taken for study. 33 patients meeting the criteria were taken for analysis. International
Prognostic Index for each patient was worked out based upon their age, LDH level, Performance Status, involved extranodal sites and stage. Regression analysis was done to which factors were
most sensitive to IPI. Duration at presentation was correlated with IPI.

Result: In this study 57.5% were male, 42.5% female. Median age was 58 years. Patients presented at median of 15 weeks from their first symptom. About 70% had pain and half reported B symptoms. Among 5 factors contributing to IPI, Raised LDH was seen in 24 (72%) cases, stage > 2 in 18 (55%), PS of >= 2 in 13 (39%), 12 (36%) were above 60 years and only 4 (12%) had more than one extra nodal sites involved. IPI grouping shows higher proportion of patients in low or low intermediate group (19, 57%) while in age adjusted risk grouping there were 18 or 54% of
patients in high or high intermediate risk group. Correlation coefficient for B symptoms is -.005 and is non-significant.

Conclusion: Symptom duration was not correlated with IPI score. In this group IPI score is most sensitive to having >1 extra nodal sites involved and raised LDH. Further larger trials is desired to
confirm or refute these findings.

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