Diffuse large B-cell lymphoma in the older

Gutiérrez, Antonio; Mestre, F.; Perez-Manga, G.; Rodríguez, José A.

doi:10.1016/j.critrevonc.2010.02.009

Cited by 8 publications

(8 citation statements)

References 101 publications

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“…But, according to another approach, the less favorable outcome of the ABC-type DLBCL is also enhanced by the fact that it is generally diagnosed in patients older than those with GCB-type DLBCL, i.e. the ABC-type DLBCL carries a worse IPI-score already by itself [19,20].…”

Section: Discussionmentioning

confidence: 95%

Spontaneous Remission in Localized Diffuse Large B-cell Lymphoma

Tamas

Sári

Répássy

et al. 2011

Pathol. Oncol. Res.

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Diffuse large B-cell lymphoma (DLBCL) is an aggressive neoplastic disease of the lymphatic system, the activated B-cell type of this disease is likely to have a substantially worse prognosis. In this study, we report the favorable outcome of the activated B-cell type of DLBCL, though untreated, 7 years after diagnosis. In 2003, DLBCL localized to the root of tongue was found in the patient complaining of dysphonia and a pharyngeal globus perception but the patient did not agree to get any active hematological treatment. During the following years, the patient did not have any complaints. At the otorhinolaryngological control examination, in 2010, she was complaint-free, had normal laboratory parameters. Moreover a PET-CT scan did not reveal metabolic activity relating to malignancy. The extraordinary disease process can be explained by the spontaneous regression of the activated B-cell type DLBCL. Spontaneous regression of oral lymphoma has been published only exceptionally. To our knowledge, no report of spontaneous regression of activated B-cell type DLBLC has been reported.

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Section: Discussionmentioning

confidence: 95%

Spontaneous Remission in Localized Diffuse Large B-cell Lymphoma

Tamas

Sári

Répássy

et al. 2011

Pathol. Oncol. Res.

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“…Rather than intrinsic tumor resistance, the main possibilities are supposed to be associated with comorbidities, declined function reserve, inadequate intensity or density of treatments, and relative immune dysfunction in the eradication of residual diseases. 3,5 Nevertheless, frail older patients may not be able to tolerate aggressive treatments, which can be identified by comprehensive geriatric assessment. 18,19 In this study, patients in the very elderly group with poorer renal function were less likely to receive chemotherapy, as well as the full course of first-line chemotherapy, which may result in different treatment outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…8,14 Age more than 60 years defined as old age in the risk stratification system by the International NonHodgkin's Lymphoma Prognostic Factors Project is generally agreed, but the age criteria need to be modified according to social, cultural, geographical, and chronological backgrounds. 3 Although age is a simple and practical concept in the lymphoma risk stratification system, it deserves more extensive considerations when treatment strategy has been changed and life expectancy has been prolonged nowadays. While E-IPI was proven to be an efficient prognostic system under immunochemotherapy with R-CHOP in the previous report, 7 the present study was the first to report the comparison of values of E-IPI before and after the addition of rituximab.…”

Section: Discussionmentioning

confidence: 99%

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Impact of cutoff age in predicting clinical outcomes of elderly diffuse large B cell lymphoma receiving rituximab or not: A hospital-based study

Chen

Lin

2012

Journal of Clinical Gerontology and Geriatrics

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a b s t r a c tBackground/Purpose: Elderly lymphomas are usually defined as disease onset at age more than 60 years according to the criteria of the International Prognostic Index (IPI). IPI, the standard risk stratification system of aggressive lymphoma, was proposed before the introduction of rituximab (a monoclonal antibody of CD20). While rituximab has markedly improved the outcomes of diffuse large B cell lymphomas (DLBCL), the appropriateness of IPI has been questioned. Meanwhile, applying modified IPI to patients at extreme age has also been suggested in some reports. Hence, this study aims to evaluate the impact of Elderly-IPI (E-IPI) with cutoff age at 70 years in elderly DLBCL receiving rituximab or not. Methods: In a tertiary medical center, DLBCL patients older than 60 years were enrolled between January 2000 and December 2009. We excluded patients who did not receive first-line chemotherapy with CEOP/CNOP (cyclophosphamide, epirubicin/mitoxantrone, vincristine, and prednisone) plus rituximab or not. Patient characteristics and treatment outcomes were analyzed. Results: In total, 139 patients were included. Age cutoff 70 years was a significant impact factor in overall survival (OS) and progression-free survival (PFS) (p ¼ 0.0044 and 0.0468). For the entire population, age more than 70 years was demonstrated to be an independent poor predictor in the multivariate analysis of OS (Hazard ratio: 3.441; 95% CI: 1.761e6.725; p < 0.001) and PFS (Hazard ratio: 1.934; 95% CI: 1.104e 3.388; p ¼ 0.021). In comparison with IPI (p ¼ 0.0001 and 0.2126), E-IPI (p < 0.0001 and p ¼ 0.0285) had significantly greater impact on OS and PFS. In the subgroup analysis, the statistical power of E-IPI and IPI influences were superior in the group receiving no rituximab versus the rituximab counterpart. Conclusion: In DLBCL with old age, age cutoff of 70 years demonstrated promising significance in survival and prognosis. In addition, E-IPI seemed more practical than IPI in the era of rituximab. Because of the limited numbers of patients analyzed in this retrospective study, further large-scale investigations are warranted to confirm these results.

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“…Thus, age itself is considered an adverse prognostic factor. Gutierrez et al (13) reported an increase in the incidence of DLBCL in the elderly. Multiple factors, including an increase in life expectancy, may well be an important factor contributing this increase.…”

Section: Discussionmentioning

confidence: 99%

Diffuse large B-cell lymphoma, not otherwise specified of the palate: a case report

Souto¹,

Pereira²,

Castro³

et al. 2013

J Clin Exp Dent

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Diffuse large B-cell lymphoma (DLBCL) is the most frequent type of non-Hodgkin´s lymphoma found in oral and maxillofacial regions. A large number of cases may be biologically heterogeneous, which are commonly defined as DLBCL, not otherwise specified (NOS) by the World Health Organization (WHO-2008). The present case reports on an ulcer of raised and irregular edges, found on the border between the hard and soft palate, as the first and only manifestation of an extranodal non-Hodgkin lymphoma in an 85-year-old patient. Incisional biopsy was carried out, and the specimen revealed a proliferation of large lymphoid cells suggestive of diffuse large cell lymphoma. An immunohistochemical analysis was performed. EBV-RNA was assessed by in situ hybridization that also proved to be negative. Immunohistochemical and EBV analyses are important to avoid delays and inappropriate treatment strategies. Although advanced age is considered an adverse prognostic factor, early diagnosis did prove to be a key contributory factor in the cure of non-Hodgkin lymphoma. Key words:Diffuse large B-cell lymphoma, elderly, EBV.

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Diffuse large B-cell lymphoma in the older

Cited by 8 publications

References 101 publications

Spontaneous Remission in Localized Diffuse Large B-cell Lymphoma

Spontaneous Remission in Localized Diffuse Large B-cell Lymphoma

Impact of cutoff age in predicting clinical outcomes of elderly diffuse large B cell lymphoma receiving rituximab or not: A hospital-based study

Diffuse large B-cell lymphoma, not otherwise specified of the palate: a case report

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