Factors associated with unresponsiveness to treatment in patients with non-Hodgkin lymphoma: 10 years of experience from a single center

Aim: To investigate factors associated with response to treatment in non-Hodgkin lymphoma (NHL) patients receiving chemo(radio)therapy, and secondarily, to identify parameters influencing mortality. Methods: This was a retrospective single center study carried out between January 2013 and December 2022. A total of 245 patients newly diagnosed with NHL who were treated in our department were included. Clinicodemographic features, NHL characteristics, treatments and follow-up data were retrieved from the hospital database and charts. Patients were grouped as responders (RT) and non-responders (NRT) to treatment, as well as deceased (DP) and survivors (SP). Factors associated with response to treatment and mortality were determined by univariate and multivariable analysis. Results: Age was similar in the RT (56.2 ± 14.5) and NRT (59.5 ± 13.7) groups; however, male sex was significantly more frequent in the RT group (58.1% vs. 35.71%; p = 0.042). Multiple logistic regression revealed that female sex, low performance status, frailty, high lymphocyte level, extranodal involvement, mantle cell lymphoma, thrombocytopenia during treatment, and cardiac complications during treatment were independently associated with no response to treatment. With respect to groups based on mortality, the DP group was significantly younger compared to the SP group (50.8 ± 11.7 vs. 57.1 ± 14.6; p = 0.048), while sex distribution was similar (males comprised 54.7% of the DP and 63.6% of SP group). Multiple regression showed that extranodal involvement, thrombosis during treatment, and secondary malignancy were independently associated with mortality. Conclusion: Considering these characteristics when making treatment decisions and throughout the follow-up period may improve survival and reduce mortality in NHL.