Poor Prognosis of Diffuse Large B-Cell Lymphoma of the Breast: The Role of Dose-Dense Chemotherapy

Abstract

Background: The aim of the study was to define if the use of an intensive regimen (dose-dense) of chemotherapy may improve response rate and outcome in patients with primary breast lymphoma (PBL), whose is considered as lymphoma presentation with an worse prognosis. Methods: Patients with pathological confirmed diagnosis of diffuse large B-cell lymphoma with clinical presentation on breast (PBL) , > 18 years old, stage I and II, negative for immunodeficient syndrome, hepatitis A and B, previously untreated , with non-germinal center cell, were included in a open label clinical trial, phase II, were allocated to received an dose dense regimen of CHOP (cyclophosphamide , doxorubicine, vincristine and prednisone) Results: Between July 2006 to December 2016, seventy eight patients were enrolled in the study. Complete response was achieved in 76 (94.4%), patients. Five patients relapse , thus progression free survival at 5 years was 94.0% (95 % Confidence interval (CI): 87% to 98%%): three patients achieved a second response and are alive, overall survival at 5-years was : 95.3 (96%CI: 89% to 102%).Relapse at central nervous system has not been observed. Severe granulocytopenia was observed in 42.8 (93.0%) cycles, but no death associated to treatment were observed. Conclusion: The use a dose-dense regimen of chemotherapy improve outcome in this setting of patients; although severe acute toxicities were frequent , it well controlled. Relapse in central nervous system has not been observed. Thus, we considered that dose-dense chemotherapy will be employed in this setting of patients.