Clinical characteristics and treatment outcome of 218 patients with non-Hodgkin's lymphoma in a Singaporean institution.

A retrospective analysis of 218 patients with non-Hodgkin's lymphoma (NHL) seen at a single institution in Singapore over a ten-year period was conducted. Twenty percent, 56% and 24% of patients had low-, intermediate- and high-grade disease respectively using the Working Formulation, and 25% of patients immunophenotyped had T-cell NHL. Forty-nine percent had primary extranodal disease, with the commonest sites of involvement being the gastrointestinal tract, nasal cavity, and tonsils. 86% and 73% respectively of patients with intermediate and high grade disease received combination chemotherapy as first line treatment, with CHOP being the most commonly used regime. Seventy-four percent of patients with low grade lymphoma received first line chemotherapy, 5% each was treated with radiotherapy or surgery alone, and 21% was treated symptomatically. Patients with low grade B-cell lymphoma had a 5-year survival of 80% and 10-year survival of 42%. One-year survival for intermediate and high grade B-cell lymphoma was 76% and 42%, while 2-year survival was 67% and 42% respectively. 1-, 2-, and 3-year survival for patients with T-cell lymphoma was 67%, 46% and 37% respectively. The difference in survival between low-, intermediate- and high-grade B-cell lymphoma was statistically significant (p = 0.0018 using the log rank test), but that between B- and T-cell lymphoma was not. Using the Cox regression model, International prognostic index, grade and extranodal disease were found to be statistically significant predictors of survival (p = 0.0001, p = 0.0157, p = 0.0343) respectively.