Prognostic Value of Serum Soluble IL2 Receptor (sIL2R) Level in Patients with Diffuse Large B Cell Lymphoma (DLBCL), Treated with CHOP or R-CHOP Based Therapy.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 1569-1569
Author(s):  
Yasuhiro Oki ◽  
Keitaro Matsuo ◽  
Harumi Kato ◽  
Kazuhito Yamamoto ◽  
Yoshitoyo Kagami ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Prognostic Factors ◽  
B Cell ◽  
Cell Lymphoma ◽  
Prognostic Significance ◽  
B Cell Lymphoma ◽  
Entire Group ◽  
Extranodal Involvement ◽  
The Impact

Abstract Emergence of rituximab (R) has significantly changed the clinical outcome of patients with B-cell lymphoma, which necessitates investigators to reassess the roles of previously determined prognostic factors. We performed a retrospective study to clarify the prognostic significance of serum sIL2R levels among other factors in patients with DLBCL. Study group consisted of 208 consecutive untreated patients with DLBCL who had serum sIL2R levels examined prior to treatment, and were treated in our institution between January 1999 and December 2006. Patients were treated with CHOP based chemotherapy without (R-, n=112) or with (R+, n=96) rituximab. Median follow up duration of each group was 55 and 19 months, respectively. Age (18–92), performance status (PS, ≥2 or <2), B symptoms (present or absent), stage (1–4), number of extranodal involvement (≥2 or <2), bulky diseases (largest diameter of the disease ≥ 10cm, present or absent) serum LDH levels and sIL2R levels were available in all patients. Beta-2 microglobulin levels were available in 130 patients. Serum sIL2R levels ranged from 316 to 35100 U/mL (median 1080), while standard range in healthy individuals was <520 U/mL. Spearman correlation analyses revealed that Log sIL2R level (LsIL2R) was associated with age (p<0.001), PS (p<0.001), B symptoms (p<0.001), stage (p<0.001), number of extranodal involvement ≥2 (p<0.001), Log LDH level (LLDH) (p<0.001) and beta2 microlobulin (p<0.001). The impact of each factor on overall survival (OS) was analyzed by Cox proportional Hazard model. Univariate analyses revealed that age (Hazard ratio [HR]=1.034, p=0.010), stage (HR=1.357, p=0.021), B symptoms (HR=1.152, p<0.001), R− (HR=2.123, p=0.049), PS (HR=4.102, p<0.001), number of extranodal involvement ≥2 (HR=2.592, p<0.001), LsIL2R (HR=3.249, p<0.001), LLDH (HR=4.378, p<0.001) and beta2 microglobulin (HR=1.283, p<0.001) were associated with shorter OS. When analyses was performed separately in R− and R+ groups, HR of LsIL2R was 3.59 (p<0.001) and 2.92 (p=0.071), respectively. Multivariate analysis in the entire group revealed that age (HR=1.030, p=0.041), PS (HR=2.089, p=0.038), B symptoms (HR=2.307, p=0.022), R− (HR=2.721, p=0.038), and LsIL2R (HR=2.140, p=0.018) were independently associated with shorter OS. When multivariate analysis was performed in R− group alone, age (HR=1.035, p=0.035), B symptoms (HR=3.565, p=0.001), and LsIL2R (HR=2.704, p=0.004) independently correlated with shorter OS. In the group of R+, only PS was left as an independent prognostic factor (HR=5.304, p<0.001). When LsIL2R was put back into the multivariate model of R+ group, HR of PS and LsIL2R became 4.308 (p=0.035) and 2.383 (p=0.165), respectively. In conclusion, serum sIL2R levels are frequently elevated in untreated patients with DLBCL and the higher level is significantly associated with shorter OS, independent of other known prognostic factors. When analysis was limited to R+ group, known prognostic factors such as age were not deemed independently associated with OS possibly due to short follow up duration and excellent prognosis in this population (estimated 3-year OS rate of 88%); thus longer follow up of this large cohort is necessary. Updated analyses for OS and various different analyses, such as analyses for correlation with complete response or time to treatment failure will be presented to further clarify the value of sIL2R levels.

scholarly journals Osteopontin expression and its relationship with prognostic factors in diffuse large B-cell lymphoma

2019 ◽  
Vol 11 (3) ◽  
Author(s):  
Gilberto Barranco ◽  
Edith Fernández ◽  
Silvia Rivas ◽  
Roxana Quezada ◽  
Dolores Nava ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
B Cell ◽  
Germinal Center ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Cox Proportional Hazards ◽  
Biological Behavior ◽  
Large B Cell Lymphoma ◽  
The Impact ◽  
Large B Cell

The aim of this study is to explore the expression of osteopontin (OPN) and its relationship with prognostic factors and survival in diffuse large B cell lymphoma (DLBCL). A tissue microarray was performed for immunohistochemical evaluation. Contingency tables were analyzed for trends; chi-square test was used to determine differences between groups. Univariate and multivariate Cox proportional hazards-regression analyses were performed to evaluate the impact of prognostic factors on survival. Expression of OPN was observed in 28%. It was different in non-germinal center DLBCL (P=0.04). The mean overall survival (OS) was lower in patients with positive OPN expression (19.762; CI 95% 14.269-25.255) it was not significant (P=0.123). It is not possible to establish a clear relationship between the expression by immunohistochemistry of osteopontin and a poor prognosis but it would be important to complement the analysis with other techniques as PCR or NGS that allow us to assess the influence of the isoforms and post-translational modifications of OPN on the biological behavior of DLBCL. Our findings indicate that OPN expression could be associated with a more aggressive variant of lymphoma: non-germinal center DLBCL.

scholarly journals Prognostic Significance of Pretreatment Neutrophil/Lymphocyte Ratio and Platelet/Lymphocyte Ratio in Patients with Diffuse Large B-Cell Lymphoma

2018 ◽  
Vol 2018 ◽  
pp. 1-8 ◽  
Author(s):  
Siqian Wang ◽  
Yongyong Ma ◽  
Lan Sun ◽  
Yifen Shi ◽  
Songfu Jiang ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
B Cell ◽  
Cell Lymphoma ◽  
Univariate Analysis ◽  
Prognostic Significance ◽  
B Cell Lymphoma ◽  
Cox Regression Analysis ◽  
Lymphocyte Ratio ◽  
Large B Cell Lymphoma ◽  
Large B Cell

It is generally believed that there is correlation between cancer prognosis and pretreatment PLR and NLR. However, there are limited data about their role in diffuse large B cell lymphoma (DLBCL). This study aims to determine the prognostic value of pretreatment PLR and NLR for patients who have DLBCL. The associations between clinical characteristics and NLR and PLR were evaluated among 182 DLBCL patients from January 2005 to June 2016. The optimal cutoff values for high PLR (⩾150) and NLR (⩾2.32) in prognosis prediction were determined. The effect of NLR and PLR on survival was evaluated through multivariate Cox regression analysis, univariate analysis, and log-rank test. According to the evaluation results, patients with high NLR and PLR had significantly shorter OS (P=0.026 and P=0.035) and PFS (P=0.024 and P=0.022) compared with those who have low PLR and NLR. On multivariate analyses, IPI>2, elevated LDH, and PLR⩾2.32 were prognostic factors for OS and PFS in DLBCL patients. Therefore, we demonstrated that high PLR and NLR predicted adverse prognostic factors in DLBCL patients.

The Impact of Relative Dose Intensity (RDI) of CHOP on Outcome of Diffuse Large B-Cell Lymphoma: Results of a Single Center Study.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 4456-4456
Author(s):  
Yoshiki Terada ◽  
Hirohisa Nakamae ◽  
Takahiko Nakane ◽  
Hideo Koh ◽  
Yasunobu Takeoka ◽  
...  
Keyword(s):  
B Cell ◽  
Clinical Outcomes ◽  
Cell Lymphoma ◽  
Dose Intensity ◽  
B Cell Lymphoma ◽  
Relative Dose Intensity ◽  
Large B Cell Lymphoma ◽  
The Impact ◽  
Large B Cell

Abstract Introduction: The achievement of a clinical response to the first induction chemotherapy has been considered for predicting survival in patients (pts) with aggressive non-Hodgkin lymphoma (NHL). Reduced dose intensity of chemotherapy has been likely to compromise long-term outcome of the patients with aggressive NHL treated with a standard chemotherapy of cyclophosphamide (CY), doxorubicin (ADR), vincristine and prednisone (CHOP). In particular, recent studies have revealed the relevance of relative dose intensity (RDI) to clinical outcomes, with reduced RDI leading to a poor survival, as well as the impact of RDI<85% for aggressive NHL with detailed analysis of risk factors influencing reduce RDI<85% (Gary H. Lyman, J. Clin Oncol22: 4302, 2004). This study was conducted to investigate the impact of RDI<85% of CHOP on outcomes of the pts with diffuse large B-Cell lymphoma (DLCL). Methods: Data were retrospectively collected on 100 pts with DLCL who had been initially treated with more than 3 courses of CHOP (n=70) or CHOP plus rituximab (CHOP-R, n=30) at our institution between 1995 and 2006. We evaluated whether RDI might affect clinical outcomes, including complete response (CR) and event free survival (EFS). The average RDI derived from CY and ADR (referred to as RDI-CY/ADR) was determined for each patient, with classified into 2 populations according to the differences from the value of 85%, including RDI-CY/ADR<85% (n=60), and RDI-CY/ADR≥85% (n=40). Results: The median age of the study population was 54 years (range, 17 to 76), with 36 pts older than 60 years (yrs) of age. According to International Prognostic Index (IPI) score, pts were classified into 2 groups of low/ low-intermediate (n=46) and high/ high-intermediate (n=54). The overall CR rate reached 62%, and the probability of overall survival (OS) or EFS at 5 years estimated 77% or 43%, respectively with a median follow-up of 13.3 months. Multivariate analysis identified RDI-CY/ADR<85%, as well as IPI score to be associated with CR rate and EFS. Thus, RDI-CY/ADR<85% and IPI score of high/ high-intermediate were significant factors for lower CR rate (as RDI-CY/ADR≥85%, HR=0.3, 95% CI 0.1 to 0.7, p=0.009, and HR=5.5, 95% CI 2.2 to 14, p<0.001, respectively), and for reduced EFS (HR=1.9, 95% CI 1.0 to 3.7, p=0.048, and as IPI score of low/ low-intermediate HR=0.3, 95% CI 0.2 to 0.6, p<0.001, respectively). Furthermore, logrank analysis revealed that CY/ADR-RDI<85% was the significant factor for reduced EFS in non elderly pts (≤60 yrs of age), or in pts with IPI score of low/ low-intermediate (p=0.01, p=0.02, respectively). Conclusion: These data thus suggested the impact of RDI-CY/ADR<85% in influencing outcomes of the pts with DLCL, in terms of CR rate and EFS. Further investigation is currently planned to confirm this promising results with longer follow-up in larger numbers of pts with NHL.

Clinical Outcomes in Patients with Diffuse Large B Cell Lymphoma with Partial Responses to First-Line R-CHOP Chemotherapy: Prognostic Value of Secondary IPI Scores and FDG-PET

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 4205-4205
Author(s):  
Hyewon Lee ◽  
Yu Ri Kim ◽  
Soo-Jeong Kim ◽  
Yong Park ◽  
Hyeon-Seok Eom ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Prognostic Factors ◽  
B Cell ◽  
Fdg Pet ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
First Line ◽  
Large B Cell Lymphoma ◽  
Deauville Score ◽  
Large B Cell

Abstract Background: Rituximab-containing chemoimmunotherapy (R-CHOP) is a standard treatment for patients with diffuse large B cell lymphoma (DLBCL), with a high response rate. Achievement of only a partial response (PR) was regarded as treatment failure, but data on their prognosis are limited to date. Distinguishing PR from CR is not always clear because of controversies in interpreting 18-fluorodeoxyglucose positron emission tomography (FDG-PET) in rituximab-era. Recent advances have prompted a revision in the response criteria, as recently suggested at the 12th International Conference of Malignant Lymphomas (ICML), emphasizing the prognostic significance of FDG-PET results interpreted using the five-point Deauville score. Based on such changes, the prognosis of PR patients should be re-evaluated. Patients and Methods: We conducted a retrospective multicenter study on behalf of the Consortium for Improving Survival of Lymphoma (CISL), to investigate survival outcomes and to define prognostic factors for PR patients after first-line treatment. A total of 758 patients with histologically proven DLBCL, who received the R-CHOP regimen between January 2005 and December 2013, were assessed. Among them, patients who achieved a PR defined by both computed tomography (CT) and FDG-PET at the end of R-CHOP were included in further analysis. Clinical information at diagnosis and after treatment was collected to determine the prognostic factors affecting the clinical outcome of PR patients. FDG-PET scans were reviewed by physicians and nuclear medicine experts in each institution and interpreted using the Deauville five-point scale. The prognostic role of secondary International Prognostic Index after R-CHOP (IPI2), assessed by restaging, age, performance status, residual multiple extranodal involvements and lactate dehydrogenase (LDH) levels, was evaluated. Progression-free survival (PFS2) and overall survival (OS2), measured from the date of the response assessment after R-CHOP to further progression or death, were determined by Kaplan-Meier methods with log-rank test. We also performed t-tests, χ2 tests, and Cox proportional hazard analysis. Statistical significance was accepted when two-sided p values were <0.05. Results: In total, 88 (11.6%) patients partially responded to R-CHOP with a median age of 53.5 years were searched. Over a median follow-up of 47.8 months, 3-year PFS2 and OS2 rates were 58.8% and 69.4%, respectively. The IPI2 scores were 0-1 (low) in 68.2% and ≥2 (high) in 31.8% of patients. The Deauville scores after R-CHOP were 2-3 (low) in 57.9% and 4 (high) in 42.0% of patients. High (≥2) and low (0-1) IPI2 groups represented 28% and 72% of 3-year PFS2 rates (p <0.001). Patients with Deauville score 4 were also associated with worse 3-year PFS2 rates than those with a lower score (2-3) (40.4% vs. 71.1%, p=0.009). For OS2, IPI2 (47.6% vs. 77.7%, p=0.013) and Deauville score (57.5% vs. 75.3%, p=0.067) were prognostic, although the effect of the Deauville score was not statistically significant. A high-risk group, defined by the IPI2-Deauville index (Table 1), showed significantly lower 3-year rates of PFS2 (17.1% vs. 69.3%, p<0.001) and OS2 (43.4% vs. 75.1%, p=0.006) compared with other groups (Figure 1). In a multivariate analysis, the IPI2-Deauville index was an independent prognostic factor for disease progression (HR 1.76, 95% CI 1.15-2.69, p=0.009), adjusted with initial IPI score and bone marrow involvement at diagnosis. For OS2, the index did not remain significant in a multivariate analysis. Conclusion: Our data shows that patients with DLBCL who achieved a PR to R-CHOP is still a heterogeneous group, and IPI2 and Deauville scores can be useful prognostic factors in addition to initial IPI at diagnosis. Validation through future prospective study would be valuable. Disclosures No relevant conflicts of interest to declare.

Impact of absolute lymphocyte count on prognosis of aggressive non-Hodgkin lymphoma.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e19034-e19034
Author(s):  
Anahat Kaur ◽  
Punita Grover ◽  
Sheetal Bulchandani ◽  
Thomas A Odeny ◽  
Sheshadri Madhusudhana ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
B Cell ◽  
Hodgkin Lymphoma ◽  
Lymphocyte Count ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Absolute Lymphocyte Count ◽  
Intermediate Risk ◽  
Non Hodgkin Lymphoma

e19034 Background: Multiple studies have attempted to identify parameters to predict prognosis and overall survival (OS) in Non-Hodgkin Lymphoma (NHL). Revised International Prognostic Index (R-IPI) is commonly used but does not capture all predictive risk factors in the Rituximab era. Low absolute lymphocyte count (ALC) on follow up after first line therapy has been reported to predict relapse. The prognostic value and exact cut off for low ALC at diagnosis is not known. We aimed to investigate whether ALC at time of diagnosis is an independent predictor for OS in aggressive NHL. Methods: We retrospectively evaluated patients with aggressive NHL treated at our center from 1/2000 to 12/2016 with at least 2 year longitudinal follow up after diagnosis. We retrieved data for baseline characteristics including age, sex, Ann Arbor stage, R-IPI score, HIV status, histopathological diagnosis (Diffuse Large B Cell Lymphoma (DLBCL), Burkitt′s lymphoma, Follicular Lymphoma Grade IIIB, high-grade B cell lymphoma), type of chemotherapy and clinical response. Patients were divided into four subgroups based on ALC at diagnosis: < 500, 501-1000, 1001-1500 and > 1500X109/L. Statistical analysis was done using REDCAP and Stata v13. Results: A total of 92 patients were identified. The average age at diagnosis was 53.4 years, 63% were male and 73.5% were diagnosed with DLBCL. Per R-IPI score, 16.3% were high risk, 31.3% were high intermediate risk, 22.5% low intermediate risk and 30% were low risk. The median OS for patients with ALC < 500 x109/L (5.4%) was 1.5 years, ALC 501-1000 (38%) was 2.3 years, ALC 1001-1500 (23.9%) was 4.25 years and ALC > 1500 (32.6%) was 5.2 years. On multivariate analysis this difference was not statistically significant due to small sample size. Conclusions: We found that low ALC at diagnosis trended towards worse OS in aggressive NHL but did not reach statistical significance on multivariate analysis. Our study is limited by retrospective nature and sample size. Multicenter studies need to be done to validate these results. Studies are also needed to know the exact cut off for low ALC. [Table: see text]

scholarly journals Autologous Stem Cell Transplantation for Primary Mediastinal B Cell Lymphoma in the Rituximab Era: A Retrospective Study By the EBMT Lymphoma Working Party

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 1195-1195
Author(s):  
Irit Avivi ◽  
Ariane Boumendil ◽  
Hervé Hervé Finel ◽  
Arnon Nagler ◽  
Aïda Sousa Bothello ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Stem Cell ◽  
Retrospective Study ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Refractory Disease ◽  
Post Transplant ◽  
The Impact

Abstract Introduction: The addition of rituximab to induction therapy had improved the outcome of patients with primary mediastinal B cell lymphoma (PMBCL). For those patients who are primary refractory or relapse after having achieved a remission, high-dose therapy and autologous stem cell transplantation (ASCT) is considered as standard treatment. Only scanty information, however, is available regarding the role of ASCT in patients with relapsed / refractory PMBCL in the rituximab era. Moreover, the impact of pre- and post-transplant irradiation remains uncertain. The objective of the current study was to investigate the results of ASCT for PMBCL in the rituximab era, identify variables predictive for outcome, and assess the role of adjuvant radiotherapy. Patients and methods: For this retrospective study, all EBMT registered patients with PMBCL aged between 18 and 70 years who were treated with a first ASCT between 2000 and 2012 were eligible. Baseline patient, disease, and transplant data were collected from MED-A forms. Centers with potentially eligible patients were contacted to provide additional treatment and follow-up information including a written histopathology report. Statistical analysis used log rank test to assess the impact of baseline characteristics on survival endpoints. In multivariate analysis, the relevance of prognostic factors was estimated using Cox regression models. Curves of cumulative incidence of relapse (IR) were compared by Gray's test. Multivariate analysis of IR used Fine and Gray models. Results: 86 patients with confirmed PMBCL were eligible and had the full data set required for this analysis. 51% were female, median age was 34 years (range 20-69). Median time from diagnosis to ASCT was 12 months (12-299). 63.5% of the patients presented with a bulky mediastinal mass, larger than 10cm at diagnosis, 30.5% had stage IV disease, and 44% had B symptoms. 92% had received at least 2 lines of therapies, 85% had rituximab and 30% had received radiotherapy prior to transplantation. At ASCT, 11% still had a mass greater than 10 cm, and 19% a mass of 5-10cm. Remission status at ASCT was CR/PR1 in 21% of the patients, CR/PR>1 in 51%, and refractory disease in 28%. 31 patients (41%) received irradiation post-transplant. Thirteen patients of 24 patients (54%) transplanted in PR attained CR at day +100 post ASCT. With a median follow-up of 39 months (24-73), 3-year non-relapse mortality, IR, event-free survival (EFS) and overall survival (OS) for the whole series were 9%, 33%, 58% and 71%, respectively. By univariate analysis, refractory disease at ASCT and residual mass > 5cm at ASCT were significant adverse predictors for IR, EFS, and OS. 3-year EFS was 35% in refractory subjects vs 66% in chemosensitive patients (p=0.001), and 100% in those autografted in CR/PR1 vs 60% in those transplanted in more advanced response p=0.018. Notably, patients transplanted with refractory disease with a history of irradiation prior to ASCT had a superior outcome compared with non-irradiated refractory patients.Multivariate analysis suggested post-transplant irradiation to be associated with a significantly reduced IR (HR=0.24; p=0.028) and improved EFS (HR=0.24; p=0.018) and OS (HR=0.21; p=0.032). Discussion: In conclusion, this analysis gives first specific evidence that ASCT can provide durable remissions in patients with relapsed / refractory PMBCL in the rituximab era. Pre or post-transplant irradiation appears to be important, though deserves further studies. Disclosures No relevant conflicts of interest to declare.

HIV-Associated Plasmablastic Lymphoma: A Multi-Institutional Study

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 1589-1589
Author(s):  
Michael Furman ◽  
Pascual Balsalobre ◽  
Brady E Beltran ◽  
Michele Bibas ◽  
Mark Bower ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Hiv Infection ◽  
B Cell ◽  
Research Funding ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Hiv Positive ◽  
Multivariate Survival Analysis ◽  
Extranodal Involvement ◽  
Multivariate Survival

Abstract Abstract 1589 Background: Plasmablastic lymphoma (PBL) is a distinct subtype of B-cell lymphoma strongly associated with HIV infection with no more than 150 cases reported in the literature. We conducted a retrospective study to evaluate clinicopathological characteristics and determine prognostic factors in HIV-associated PBL (HIV PBL). Methods: Institutions in the United States (US) and internationally submitted clinical and pathological patient-level data on HIV-positive individuals who had a pathological diagnosis of PBL. According to WHO criteria, all the cases were required to have a plasmablastic morphology, be CD20-negative and to express at least one plasmacytic marker (i.e. CD38, CD138 and/or MUM1/IRF4). Continuous and categorical variables are presented using descriptive statistics. Univariate survival analyses were performed using the Kaplan-Meier method and the log-rank test. Cox proportional-hazard regression test was used for the multivariate survival analysis. P-values of less than 0.05 were considered statistically significant. Results: Thus far, data on 45 patients have been obtained from 11 institutions. Twenty cases (44%) were from Europe, 17 (38%) from the US, 4 (9%) from Africa and 4 (9%) from South America. The median age was 43 years (range: 19–66 years). Of 45 patients studied, 78% (n=35) were men. The median CD4+ count was 177 cells/mm3 (range: 17–683 cells/mm3). The median duration of HIV infection prior to PBL diagnosis was 6 years (range 0–26 years), and 80% (n=36) received HAART. PBL was the initial presentation of HIV infection in 29% (n=13) of the patients. The median viral load at presentation was 45,000 copies/ml (range: undetectable to 4.7 million copies/ml). At presentation, 69% (n=25) of patients exhibited B symptoms, 44% (n=20) had extranodal involvement, 65% (n=28) presented with stage III or IV disease, 20% (n=9) had oral involvement and 39% (n=12) had an absolute lymphocyte count (ALC) <1000 cells/mm3. EBV-encoded RNA was expressed in 94% (n=31), Ki67 >90% was seen in 66% (n=21) and MYC rearrangement was detected in 50% (n=10) of tested patients. Chemotherapy was employed in 89% (n=39) of patients, with 59% (n=23) receiving CHOP. A minority (n=4; 10%) underwent HSCT. Complete response (CR) was obtained in 69% (n=22); however, after 48 months of follow-up, 66% of patients (n=29) have died. The median overall survival (OS) was 11 months (95% CI 7–20 months) from diagnosis. The most common cause of death was PBL progression (n=18; 62%). At the univariate level, adverse prognostic factors for survival included non-CR to chemotherapy (p =0.002), ALC <1000 cells/mm3 (p =0.006), MYC rearrangement (p =0.0005), ECOG performance status >1 (p =0.048), female sex (p =0.02), and advanced stage (p =0.047). At the multivariate level, ALC <1000 cells/mm3 and non-CR were independent adverse prognostic factors in patients with HIV PBL (p =0.01 and p =0.02, respectively). Conclusions: PBL is a rare aggressive B-cell lymphoma, which tends to affect young HIV-positive men who have CD4+ counts <200 cells/mm3. Advanced stage, extranodal involvement, and tumors with EBER expression, MYC rearrangements and Ki67 >90% at presentation are common features of HIV PBL. Although showing a 69% CR to chemotherapy, the median OS remains poor at 11 months. In the multivariate survival analysis, ALC <1000 cells/mm3 and lack of achievement of CR to chemotherapy were independent adverse prognostic factors in HIV PBL. In the HAART era, HIV PBL seems to have a shorter median OS than other HIV-associated aggressive B-cell lymphomas. Disclosures: Montoto: Genentech: Research Funding; Roche: Honoraria. Vose:GSK: Research Funding; Millenium: Research Funding; Celgene: Research Funding; BMS: Research Funding; Exelixis: Research Funding; SBio: Research Funding; Pharmacyclics: Research Funding; Genentech: Research Funding. Castillo:GlaxoSmithKline: Research Funding; MIllennium Pharmaceuticals: Research Funding.

scholarly journals Prognostic Factors in Primary Cutaneous B-Cell Lymphoma: The Italian Study Group for Cutaneous Lymphomas

2006 ◽  
Vol 24 (9) ◽  
pp. 1376-1382 ◽  
Author(s):  
Pier Luigi Zinzani ◽  
Pietro Quaglino ◽  
Nicola Pimpinelli ◽  
Emilio Berti ◽  
Gianandrea Baliva ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
B Cell ◽  
Cell Lymphoma ◽  
Prognostic Significance ◽  
B Cell Lymphoma ◽  
Complete Response ◽  
Study Group ◽  
First Line ◽  
Cutaneous Lymphomas ◽  
Independent Prognostic Significance

PurposePrimary cutaneous B-cell lymphomas (PCBCLs) are a distinct group of primary cutaneous lymphomas with few and conflicting data on their prognostic factors.Patients and MethodsThe study group included 467 patients with PCBCL who were referred, treated, and observed in 11 Italian centers (the Italian Study Group for Cutaneous Lymphomas) during a 24-year period (1980 to 2003). All of the patients were reclassified according to the WHO–European Organisation for Research and Treatment of Cancer (EORTC) classification.ResultsFollicle center lymphoma (FCL) accounted for 56.7% of occurrences, followed by marginal-zone B-cell lymphoma (MZL; 31.4%); diffuse large B-cell lymphoma (DLBCL), leg type, was reported in 10.9% of patients. Radiotherapy was the first-line treatment in 52.5% of patients and chemotherapy was the first-line treatment in 24.8% of patients. The complete response rate was 91.9% and the relapse rate was 46.7%. The 5- and 10-year overall survival (OS) rates were 94% and 85%, respectively. Compared with FCL/MZL, DLBCL, leg type, was characterized by statistically significant lower complete response rates, higher incidence of multiple cutaneous relapses and extracutaneous spreading, shorter time to progression, and shorter OS rates. The only variable with independent prognostic significance on the OS was the clinicopathologic diagnosis according to the WHO-EORTC classification (DLBCL, leg-type, showed a significantly worse prognosis v FCL and MZL; P < .001), whereas the only variable with independent prognostic significance on disease-free survival was the presence of a single cutaneous lesion (P = .001).ConclusionOur study identifies a possible PCBCL subclassification and the extent of cutaneous involvement as the two most relevant prognostic factors in PCBCL. These data can be considered reasonably as the clinical background for an appropriate management strategy.

scholarly journals Clinical Characteristics and Outcome of Diffuse Large B Cell Lymphoma Among HTLV-1 Carriers in Peru: A Matched Cohort Study

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 38-39
Author(s):  
Bryan Valcarcel ◽  
Daniel J Enriquez ◽  
Gustavo Sandival-Ampuero ◽  
Ursula Aviles-Perez ◽  
Juan C Haro ◽  
...  
Keyword(s):  
B Cell ◽  
Clinical Features ◽  
Clinical Characteristics ◽  
Cox Regression ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Extranodal Involvement ◽  
Large B Cell Lymphoma ◽  
The Impact ◽  
Large B Cell

Background: Diffuse large B-cell lymphoma (DLBCL) is the most common variant of non-Hodgkin lymphoma (NHL) accounting for approximately 30% of the NHL cases worldwide. Previous reports have associated certain viral infections with the development of DLBCL such as HIV and EBV, both infections related with an aggressive clinical course and worse outcome. The human T-lymphotropic virus type 1 (HTLV-1) is a retrovirus regarded as the pathogenic agent for adult T-cell lymphoma/leukemia. HTLV-1 is endemic in Japan, the Caribbean basin, South America, and parts of Africa. In Peru, up to 3% of the healthy adult population carries HTLV-1. As data on the impact of HTLV-1 infection in DLBCL outcomes is scarce, we aim to describe the clinical features and outcomes of HTLV-1-positive patients with a pathological diagnosis of DLBCL. Methods: We retrospectively reviewed medical records of patients diagnosed and managed for DLBCL at the National Institute of Neoplastic Diseases in Lima-Peru between 2007 and 2019. Patients were evaluated for HTLV-1 infection at the time of diagnosis. Positive HTLV-1 cases were matched to negative HTLV-1 controls based on age, sex, and cancer staging. Treatment responses were assessed according to the Lugano criteria. Overall survival (OS) and event-free survival (EFS) curves were estimated using the Kaplan-Meier method and compared with the Log-rank test to determine the impact of HTLV-1 infection. Multivariate Cox regression models were reported with adjusted Hazar Ratios (aHR) with a 95% confidence interval (95% CI). Results: A total of 192 patients with DLBCL were identified and had sufficient data for analysis. Seventy (37%) cases were positive for HTLV-1 infection and 122 (63%) were not. Table 1 summarizes the clinical features and outcomes of DLBCL patients according to HTLV-1 status. Overall, the majority of patients were ≥65 years (59%), had ECOG performance status ≤2 (95%) and were stage III-IV (51%) at diagnosis. One third (n=64) of patients had extranodal involvement with 71 affected sites of which bone marrow involvement was frequently found in HTLV-1-negative DLBCL cases (55% vs. 7%, p&lt;0.001) and liver/gastrointestinal tract in HTLV-1-positive cases (48% vs. 9%, p&lt;0.001). There was no difference among DLBCL groups regarding risk stratification based on NCCN-IPI score (p=0.394). With a median follow-up of 6.5 years, we found that in DLBCL patients, HTLV-1 infection had no significant impact in 5-year OS (HTLV-1-positive 40% versus HTLV-1-negative 42%, p=0.930) and EFS rates (HTLV-1-positive 33% versus HTLV-1-negative 32%; p=0.890) (Figure 1). Multivariate cox regression analysis could not identify HTLV-1 infection as a risk factor for higher mortality or disease progression (Figure 1). Conclusion: To the best of our knowledge, this is the largest case series describing the clinical characteristics and outcome of HTLV-1-positive DLBCL patients. A study from Japan on early stage localized (head and neck) B-cell-NHL (n=198, HTLV-1 seropositive n=21 and with DLBCL n=12) treated with radiotherapy and/or multi-agent chemotherapy found poorer prognosis on HTLV-1 carriers compared to non-carriers (5-year OS: HTLV-1-positive n=21, 49% vs. HTLV-1-negative n=177, 78%, p=0.007; Hiroaki et al BJH 2003). In this study, we included DLBCL patients with both early and advanced stage disease along with localized and extranodal involvement. We found that HTLV-1 infection had no significant impact on 5-year OS and EFS rates when using conventional therapy for DLBCL. Moreover, we did not find differences in relapsed and mortality rates. Further investigation is needed to confirm the potential impact of HTLV-1 infection in DLBCL outcome. Disclosures No relevant conflicts of interest to declare.

Sign in / Sign up

Export Citation Format

Share Document