Prognostic factors in primary diffuse large B-cell lymphoma of adrenal gland treated with rituximab-CHOP chemotherapy from the Consortium for Improving Survival of Lymphoma (CISL)

Kim, Yu Ri; Kim, Jin Seok; Min, Yoo Hong; Hyunyoon, Dok; Shin, Ho Jin; Mun, Yeung Chul; Park, Yong; Rok, Young; Jeong, Seong Hyun; Park, Joon Seong; Oh, Sung Yong; Lee, Suee; Park, Eun Kyung; Jang, Joung Soon; Lee, Won Sik; Lee, Hwe Won; Eom, Hyeon-Seok; Ahn, Jae Sook; Jeong, Jooyeon; Baek, Sun Kyung; Kim, Seok Jin; Kim, Won Seog; Suh, Cheolwon

doi:10.1186/1756-8722-5-49

Cited by 87 publications

(101 citation statements)

References 30 publications

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“…Before the introduction of Rituximab in the CHOP therapy, 20-50% of overall survival rate was reported in lymphomas patients. Data by Kim et al (11) revealed a complete response rate of 54.8% and partial response rate of 32.3% after the R-CHOP therapy (11). There is a high risk of CNS relapse in primary adrenal NHL, and the risk remains almost same even after the addition of R-CHOP therapy.…”

Section: Discussionmentioning

confidence: 96%

Calcitriol-mediated Reversible Hypercalcemia in a Patient with Primary Adrenal Lymphoma

Mir

Masoodi

Wani

et al. 2016

MJMS

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Section: Discussionmentioning

confidence: 96%

Calcitriol-mediated Reversible Hypercalcemia in a Patient with Primary Adrenal Lymphoma

Mir

Masoodi

Wani

et al. 2016

MJMS

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“…Ultrasound-guided biopsy is recommend for the differential diagnosis following the identification of low density of adrenal glands on CT scan images, and immunohistochemical examination further confirm the diagnosis and prognosis. The recommended treatment regimen for PAL is R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone), a classical chemotherapy regimen (20), with chemotherapy being the typical treatment. It has been reported that surgery is not recommended for treatment (21).…”

Section: Discussionmentioning

confidence: 99%

Bilateral primary adrenal diffuse large B cell lymphoma without adrenal insufficiency: A case report and review of the literature

Chen

Jin

et al. 2017

Molecular and Clinical Oncology

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Abstract. Primary adrenal lymphoma (PAL) is an infrequent malignant tumor, occurring in the bilateral adrenal glands as a mass in the majority of cases. The current study presents a case of bilateral primary adrenal diffuse large B cell lymphoma in a 52-year-old female patient, who presented with abdominal pain in the left lumbar region for ~2 weeks. Abdominal ultrasound examination and computed tomography scanning revealed a mass of 132x119x101 mm on the left adrenal gland and a mass of 53x27 mm on the right adrenal gland. A percutaneous biopsy was performed and histopathological examination further confirmed this lesion as diffuse large B cell lymphoma. The present study highlights the importance of early diagnosis of PAL, and performs a literature review of the subject. IntroductionAlthough the adrenal glands contain no lymphoid tissue, primary adrenal lymphoma (PAL) is identified in <1% of cases of non-Hodgkin lymphoma (1). As a type of extranodal lymphoma, PAL is rare and constitutes <1% of cases of extranodal lymphomas; PAL is primarily bilateral but secondary involvement of the adrenal gland is typically unilateral (2,3). Diffuse large B cell lymphoma (DLBCL) is the most common subtype of PAL, which represents ~70% of PAL cases (4,5). Characteristically, PAL predominantly affects elderly patients without nodular lesions. Diagnosis of PAL is frequently challenging due to its nonspecific clinical manifestation and imaging results, and pathological examination is the only method of confirming this diagnosis (6). The prognosis of PAL is typically poor, and the 1-year survival rate is 17.5% (3). The current study reports a case of bilateral primary adrenal diffuse large B cell lymphoma and performs a review of the literature. Case reportIn June 2016, a 52-year-old female patient was admitted to the Department of Urology of Peking University Shenzhen Hospital (Shenzhen, China) due to abdominal pain in the left lumbar region lasting ~2 weeks. The patient had experience anorexia and weight loss of ~15 kg in the previous 0.5 months. The patient's past medical history included grade one hypertension for ~3 years and cerebral infarction ~2 years previously. On admission, physical examination revealed that no enlarged superficial lymph nodes were palpable and there was no hepatosplenomegaly. A full blood count revealed that had a hemoglobin level of 91 g/l (normal range, 115-150 g/l), a white blood cell count of 5.45x10 9 /l (normal range, 3.5-9.5x10 9 /l), 55.2% neutrophils (normal range, 40-75%), 27.2% lymphocytes (normal range, 20-50%), 13.8% monocytes (normal range, 3-10%), 3.1% eosinophils (normal range, 0.4-8%), 0.7% basophils (normal range, 0-1%), and a platelet count of 449x10 9 /l (normal range, 125-350x10 9 /l). A biochemical profile revealed a potassium level of 2.8 mmol/l (normal range, 3.5-5.3 mmol/l), a sodium level of 138 mmol/l (normal range, 137-147 mmol/l), an albumin level of 33.7 g/l (normal range, 40-55 g/l), a uric acid level of 558 µmol/l (normal range, 155-357 µmol/l), triglyceride levels of 2...

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“…Based on univariate analysis, these authors also demonstrated that the lung, liver, spleen, kidney, and skin involvement was significant. Furthermore, isolated reports have suggested that involvement of the adrenal glands [21,22], skin [23], and kidney [24] may also be associated with a poor prognosis. Moreover, we showed that a novel extranodal scoring system, using these extranodal sites, may improve the predictability of older risk prediction models.…”

Section: Discussionmentioning

confidence: 99%

A new extranodal scoring system based on the prognostically relevant extranodal sites in diffuse large B-cell lymphoma, not otherwise specified treated with chemoimmunotherapy

et al. 2016

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Extranodal involvement is a well-known prognostic factor in patients with diffuse large B-cell lymphomas (DLBCL). Nevertheless, the prognostic impact of the extranodal scoring system included in the conventional international prognostic index (IPI) has been questioned in an era where rituximab treatment has become widespread. We investigated the prognostic impacts of individual sites of extranodal involvement in 761 patients with DLBCL who received rituximab-based chemoimmunotherapy. Subsequently, we established a new extranodal scoring system based on extranodal sites, showing significant prognostic correlation, and compared this system with conventional scoring systems, such as the IPI and the National Comprehensive Cancer Network-IPI (NCCN-IPI). An internal validation procedure, using bootstrapped samples, was also performed for both univariate and multivariate models. Using multivariate analysis with a backward variable selection, we found nine extranodal sites (the liver, lung, spleen, central nervous system, bone marrow, kidney, skin, adrenal glands, and peritoneum) that remained significant for use in the final model. Our newly established extranodal scoring system, based on these sites, was better correlated with patient survival than standard scoring systems, such as the IPI and the NCCN-IPI. Internal validation by bootstrapping demonstrated an improvement in model performance of our modified extranodal scoring system. Our new extranodal scoring system, based on the prognostically relevant sites, may improve the performance of conventional prognostic models of DLBCL in the rituximab era and warrants further external validation using large study populations.

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Prognostic factors in primary diffuse large B-cell lymphoma of adrenal gland treated with rituximab-CHOP chemotherapy from the Consortium for Improving Survival of Lymphoma (CISL)

Cited by 87 publications

References 30 publications

Calcitriol-mediated Reversible Hypercalcemia in a Patient with Primary Adrenal Lymphoma

Calcitriol-mediated Reversible Hypercalcemia in a Patient with Primary Adrenal Lymphoma

Bilateral primary adrenal diffuse large B cell lymphoma without adrenal insufficiency: A case report and review of the literature

A new extranodal scoring system based on the prognostically relevant extranodal sites in diffuse large B-cell lymphoma, not otherwise specified treated with chemoimmunotherapy

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