Diffuse Large B-Cell Lymphoma: Clinical and Biological Characterization and Outcome According to the Nodal or Extranodal Primary Origin

López‐Guillermo, Armando; Colomo, Luís; Jiménez, Mónica; Bosch, Francesc; Villamor, Neus; Arenillas, Leonor; Muntañola, Ana; Montoto, Silvia; Giné, Eva; Colomer, Dolors; Beà, Sı́lvia; Campo, Elı́as; Montserrat, Emili

doi:10.1200/jco.2005.07.155

Cited by 254 publications

(238 citation statements)

References 39 publications

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“…Interestingly, Waldeyer ring involvement in this cohort was associated with improved survival, whereas extranodal involvement itself generally worsens survival. Lopez-Guillermo et al 13 also observed a positive prognostic impact of Waldeyer ring involvement on DLBCL before rituximab use. Consistent with our data, these patients were found to have significantly limited disease, better performance status, and fewer B symptoms.…”

Section: Discussionmentioning

confidence: 90%

Prognostic impact of extranodal involvement in diffuse large B‐cell lymphoma in the rituximab era

Takahashi

Tomita

Yokoyama

et al. 2011

Cancer

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BACKGROUND:Extranodal involvement is considered a poor prognostic factor for patients with diffuse large B‐cell lymphoma (DLBCL); however, the prognostic impact of specific sites of involvement has not been fully elucidated.METHODS:The authors retrospectively analyzed 1221 patients treated uniformly with standard R‐CHOP therapy between 2003 and 2006. Patients with distinct forms of DLBCL such as intravascular lymphoma, primary effusion lymphoma, pyothorax‐associated lymphoma, primary central nervous system lymphoma, and intraocular lymphoma were also excluded. The authors evaluated 26 extranodal sites of involvement with respect to prognostic impact. The median age was 64 years (range, 15‐91 years).RESULTS:Univariate analysis revealed that patients with involvement of specific extranodal sites had significantly worse overall survival (OS) than did patients without such involvement; these sites included nasal cavity, paranasal sinus, lung, pleura, small intestine, peritoneum, liver, pancreas, stomach, spleen, adrenal gland, testis, bone, bone marrow, peripheral blood, skin, and subcutaneous tissue. Patients with Waldeyer ring involvement had significantly better OS. Multivariate analysis revealed that patients with the involvement of the pleura (P < .001), small intestine (P = .015), peritoneum (P = .002), adrenal gland (P < .001), testis (P = .005), bone marrow (P < .001), and peripheral blood (P = .002) had significantly worse OS, whereas those with Waldeyer ring involvement had significantly better OS (P = .038). Subgroup analysis with the nodal and/or Waldeyer patient group also showed prognostic impact of Waldeyer ring by multivariate analysis (relative risk, 0.3; P = .04).CONCLUSIONS:Extranodal involvement affects the prognosis of patients undergoing R‐CHOP therapy for DLBCL. Cancer 2012. © 2011 American Cancer Society.

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Section: Discussionmentioning

confidence: 90%

Prognostic impact of extranodal involvement in diffuse large B‐cell lymphoma in the rituximab era

Takahashi

Tomita

Yokoyama

et al. 2011

Cancer

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“…When NHL has extranodal presence, the involved sites can be the gastrointestinal tract, bone, brain, testis, ovary, lung, nasopharynx, soft tissue, thyroid, kidney, liver, breast, skin, etc. [14,15].…”

Section: Discussionmentioning

confidence: 99%

Extensive Extranodal Involvement of Rare Sites in Non Hodgkin’s Lymphoma Detected on 18F- FDG PET-CT: A Case Report

Dhull

Sharma

Singla

et al. 2012

Nucl Med Mol Imaging

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We present a case of a 23 year-old male treated for Hodgkin's lymphoma who developed diffuse large Bcell lymphoma (DLBCL) 8 years after achieving remission. 18 F-fluorodeoxyglucose positron emission tomography computed tomography ( 18 F-FDG PET-CT) was done, which revealed extensive extranodal involvement of bilateral atria, bilateral kidneys, ileo-caecal junction and left testis along with mesenteric and retroperitoneal lymph nodal involvement. Renal and cardiac lesions were not detected by contrast-enhanced CT. Simultaneous lymphomatous involvement of rare sites such as heart, kidneys and testis in a single patient has not been reported before.

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“…Lymphomas presenting in extranodal organs with no or only minor lymph node involvement were considered primary extranodal. 11 Immunohistochemistry Four-micrometer paraffin sections from formalinfixed material were dehydrated and deparaffinized according to standard procedures. Heat-induced antigen retrieval was then performed.…”

Section: Methodsmentioning

confidence: 99%

PKC-beta II expression has prognostic impact in nodal diffuse large B-cell lymphoma

et al. 2007

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Recent studies of gene expression and immunohistochemistry have shown that protein kinase C-beta II (PKCbeta II) might have prognostic significance in patients with diffuse large B-cell lymphoma (DLBCL). We sought to determine the prognostic significance of the expression of PKC-beta II in patients with nodal DLBCL. Formalin-fixed, paraffin-embedded tissues were stained with a monoclonal antibody to PKC-beta II protein. A total of 125 patients were studied; 83 patients (66%) were in the low-risk International Prognostic Index (IPI) group. Forty-eight patients (38%) were positive for PKC-beta II. Complete remission was obtained in 70%, and was not influenced by the PKC-beta II status (67 vs 71%). The 5-year event-free survival (EFS) was worse in highrisk patients (14 vs 58%, Po0.001) and in those with PKC-beta II positivity (36 vs 49%, P ¼ 0.054). In low-risk IPI patients, PKC-beta II expression was related to a worse 5-year overall survival (OS) (60 vs 76%, P ¼ 0.033) and a worse 5-year EFS (48 vs 66%, P ¼ 0.014). In a Cox regression analysis for EFS, both PKC-beta II expression (hazard ratio ¼ 1.68, P ¼ 0.037) and the IPI (HR ¼ 3.07, Po0.001) were independent poor prognostic factors. PKCbeta II (HR ¼ 1.72, P ¼ 0.046) and the IPI (HR ¼ 5.16, Po0.001) were also independent poor prognostic factors for the OS. PKC-beta II expression, along with the IPI, were associated with a worse EFS and OS in patients with nodal DLBCL specially in low-risk IPI patients.

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Diffuse Large B-Cell Lymphoma: Clinical and Biological Characterization and Outcome According to the Nodal or Extranodal Primary Origin

Abstract: In the present series, the primary site of disease was associated with particular clinicopathologic features and outcome, though the latter largely depended on other factors.

Cited by 254 publications

References 39 publications

Prognostic impact of extranodal involvement in diffuse large B‐cell lymphoma in the rituximab era

Prognostic impact of extranodal involvement in diffuse large B‐cell lymphoma in the rituximab era

Extensive Extranodal Involvement of Rare Sites in Non Hodgkin’s Lymphoma Detected on 18F- FDG PET-CT: A Case Report

PKC-beta II expression has prognostic impact in nodal diffuse large B-cell lymphoma

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