ObjectiveTo explore the clinicobiologic features and outcomes of diffuse large B-cell lymphoma (DLBCL) patients in China according to the primary site.MethodsA total of 1,085 patients diagnosed with DLBCL in National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College during a 6-year period were enrolled. Their clinical characteristics and outcomes were analyzed according to the primary site.ResultsIn the 1,085 patients, 679 (62.6%) cases were nodal DLBCL (N-DLBCL) and 406 cases (37.4%) were extranodal DLBCL (EN-DLBCL). The most common sites of N-DLBCL were lymphonodus (64.8%), Waldeyer’s ring (19.7%), mediastinum (12.8%) and spleen (2.7%), while in EN-DLBCL, stomach (22.4%), intestine (16.0%), nose and sinuses (8.9%), testis (8.4%), skin (7.9%), thyroid (6.9%), central nervous system (CNS) (6.4%), breast (5.7%), bone (3.4%), and salivary gland (2.7%) were most common. N-DLBCL patients tend to present B symptoms, bulky disease, and elevated LDH more often, while age >60 years, extranodal sites >1, Ann Arbor stage I or II, bone marrow involvement, and Ki-67 index >90% were usually seen in EN-DLBCL. The 5-year overall survival (OS) rate and progression-free survival (PFS) rate for all patients were 62.5% and 54.2%. The 5-year OS rate for patients with N-DLBCL and EN-DLBCL were 65.5% and 56.9% (P=0.008), and the 5-year PFS were 57.0% and 49.0% (P=0.020). Waldeyer’s ring originated DLBCL possessed the highest 5-year OS rate (83.6%) and PFS rate (76.9%) in N-DLBCL. The top five EN-DLBCL subtypes with favorable prognosis were stomach, breast, nose and sinuses, lung, salivary gland, with 5-year OS rate: 70.3%, 69.6%, 69.4%, 66.7% and 63.6%, respectively. While CNS, testis, oral cavity and kidney originated EN-DLBCL faced miserable prognosis, with 5-year OS rate of 26.9%, 38.2%, and 42.9%.ConclusionsIn our study, primary sites were associated with clinical characteristics and outcomes. Compared with EN-DLBCL, N-DLBCL had better prognosis.

Diffusion Tensor Imaging (DTI) is a magnetic resonance imaging modality that enables the in-vivo reconstruction and visualization of fibrous structures. To inspect the local and individual diffusion tensors, glyph-based visualizations are commonly used since they are able to effectively convey full aspects of the diffusion tensor. For several applications it is necessary to compare tensor fields, e.g., to study the effects of acquisition parameters, or to investigate the influence of pathologies on white matter structures. This comparison is commonly done by extracting scalar information out of the tensor fields and then comparing these scalar fields, which leads to a loss of information. If the glyph representation is kept, simple juxtaposition or superposition can be used. However, neither facilitates the identification and interpretation of the differences between the tensor fields. Inspired by the checkerboard style visualization and the superquadric tensor glyph, we design a new glyph to locally visualize differences between two diffusion tensors by combining juxtaposition and explicit encoding. Because tensor scale, anisotropy type, and orientation are related to anatomical information relevant for DTI applications, we focus on visualizing tensor differences in these three aspects. As demonstrated in a user study, our new glyph design allows users to efficiently and effectively identify the tensor differences. We also apply our new glyphs to investigate the differences between DTI datasets of the human brain in two different contexts using different b-values, and to compare datasets from a healthy and HIV-infected subject.

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Purpose This study aimed to develop a prognostic nomogram in diffuse large B‐cell lymphoma (DLBCL) and compare it with traditional prognostic systems. Materials and methods We included 1,070 consecutive and nonselected patients with DLBCL in the National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences, between 2006 and 2012. A nomogram based on the Cox proportional hazards model was developed. Results The entire group were divided into the primary (n = 748) and validation (n = 322) cohorts. The 5‐year overall survival (OS) rate was 64.1% for the entire group. Based on a multivariate analysis of the primary cohort, seven independent prognostic factors including age, Ann Arbor stage, Eastern Cooperative Oncology Group performance status score, lactate dehydrogenase, β2‐microglobulin, CD5 expression, and Ki‐67 index were identified and entered the nomogram. The calibration curve showed the optimal agreement between nomogram prediction and actual observation. In addition, the concordance index (C‐index) of the nomogram for OS prediction was 0.77 (95% confidence interval [CI], 0.73–0.81) in the primary cohort and 0.76 (95% CI, 0.70–0.81) in the validation, superior to that of the international prognostic index (IPI), revised IPI (R‐IPI), and National Comprehensive Cancer Network (NCCN)‐IPI (range, 0.69–0.74, p<.0001). Moreover, in patients receiving rituximab plus CHOP (R‐CHOP) or R‐CHOP‐like regimens, compared with IPI (C‐index, 0.73; 95% CI, 0.69–0.77), R‐IPI (C‐index, 0.70; 95% CI, 0.66–0.74), or NCCN‐IPI (C‐index, 0.71; 95% CI, 0.66–0.75), the DLBCL‐specific nomogram showed a better discrimination capability (p < .0001). Conclusions The proposed nomogram provided an accurate estimate of survival of patients with DLBCL, especially for those receiving R‐CHOP or R‐CHOP‐like regimens, allowing clinicians to optimized treatment plan based on individualized risk prediction. Implications for Practice A diffuse large B‐cell lymphoma (DLBCL)‐specific prognostic nomogram was developed based on Chinese patients with DLBCL. As a tertiary hospital, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences is the number 1 ranked cancer center in China, with more than 800,000 outpatients in 2018. Patients included in this study were nonselected and came from 29 different provinces, municipalities, and autonomous regions in China. Thus, the data is believed to be representative to an extent.

This study was conducted to evaluate the effectiveness and tolerance of GDP (gemcitabine, dexamethasone, and cisplatin) regimen in patients with newly diagnosed stage IV and relapsed/refractory extranodal natural killer/T-cell lymphoma, nasal type (ENKTL).The study enrolled 41 ENKTL patients who received GDP regimen at the Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College between January 2008 and January 2015.The disease status was newly diagnosed stage IV in 15 patients and relapsed/refractory in 26 patients. The median number of cycles of chemotherapy per patient was 6 (range, 2–8 cycles). The overall response rate and complete-remission rate were 83.0% (34/41) and 41.5% (17/41), respectively. After a median follow-up of 16.2 months, 1-year progression-free survival rate and 1-year overall survival rate for the whole cohort were 54.5% and 72.7%. Grade 3 to 4 adverse events included neutropenia (34.1%), thrombocytopenia (19.5%), and anemia (14.6%).Our study has suggested high efficacy and low toxicity profile of GDP regimen in patients with newly diagnosed stage IV and relapsed/refractory ENKTL.