Subdiaphragmatic extranodal localizations at diagnosis of primary mediastinal large B-cell lymphoma: an impressive, rare presentation with no independent effect on prognosis

Karakatsanis, Stamatis; Papageorgiou, Sotirios; Michail, Michail; Angelopoulou, Maria K.; Kalpadakis, Christina; Leonidopoulou, Theoni; Katodritou, Eirini; Kotsopoulou, Maria; Kotsianidis, Ιoannis; Hatzimichael, Eleftheria; Lakiotaki, Eleftheria; Boutsis, Dimitrios; Karianakis, George; Symeonidis, Argiris; Gavriatopoulou, Maria; Panayiotidis, Panayiotis; Konstantopoulos, Kostas; Karmiris, Themis; Pangalis, Gerassimos A.; Vassilakopoulos, Theodoros P.

doi:10.1016/j.leukres.2021.106595

Cited by 4 publications

(7 citation statements)

References 13 publications

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“…PMLBCL is a highly aggressive neoplasm, characterized by a rapidly growing mediastinal tumor, usually bulky, which frequently causes superior vena cava syndrome, other compressive symptoms, and pleural and pericardial effusions. Rarely, the disease is much more extensive at the time of diagnosis involving peculiar extranodal sites, such as the kidneys, adrenals, stomach, ovary, and so on; however, bone marrow involvement is almost always absent [5][6][7][8][9]. The involvement of these peculiar extranodal sites or the central nervous system (CNS) is much more frequent at the time of relapse/progression [10].…”

Section: Introductionmentioning

confidence: 99%

Identification of Very Low-Risk Subgroups of Patients with Primary Mediastinal Large B-Cell Lymphoma Treated with R-CHOP

et al. 2021

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Background. R-CHOP can cure approximately 75% of patients with primary mediastinal large B-cell lymphoma (PMLBCL), but prognostic factors have not been sufficiently evaluated yet. Rda-EPOCH is potentially more effective but also more toxic than R-CHOP. Reliable prognostic classification is needed to guide treatment decisions.Materials and Methods. We analyzed the impact of clinical prognostic factors on the outcome of 332 PMLBCL patients ≤65 years treated with R-CHOP AE radiotherapy in a multicenter setting in Greece and Cyprus. Results. With a median follow-up of 69 months, 5-year freedom from progression (FFP) was 78% and 5-year

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Section: Introductionmentioning

confidence: 99%

Identification of Very Low-Risk Subgroups of Patients with Primary Mediastinal Large B-Cell Lymphoma Treated with R-CHOP

et al. 2021

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“…Finally, a few months ago our group published the first report on the incidence and prognostic significance of subdiaphragmatic extranodal site involvement in PMLBCL evaluating data of a large patient series treated in the cooperating Hellenic and Cypriot haematology departments. According to these results, ovarian involvement was described in only three out of 455 (0.7% or 1.0% when only females were considered) newly diagnosed PMLBCL patients ( Karakatsanis et al, 2021 ).…”

Section: Discussionmentioning

confidence: 96%

“…The tumor frequently invades the adjacent structures, including lungs, chest wall and pericardium. In general, involvement of extrathoracic distal extranodal sites is a rare event at disease presentation; only a small percentage of patients (approximately 5%) may suffer from renal, liver, adrenal or gastrointestinal involvement ( Karakatsanis et al, 2021 ). However, this is more common at progression or relapse of PMLBCL, where the kidney, central nervous system (CNS), adrenals and ovaries are more commonly affected ( Swerdlow et al, 2017 , Papageorgiou et al, 2013 , Bishop et al, 1999 ).…”

Section: Introductionmentioning

confidence: 99%

Symptomatic ovarian involvement as the initial presentation of primary mediastinal large b-cell lymphoma

Piperidou

Drandakis

Lefaki

et al. 2022

Gynecologic Oncology Reports

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“…13 Patients with kidney and/or adrenal involvement, especially those with 4-6 factors included in the CNS-IPI, remain at a particularly high risk of CNSR. 13 Primary mediastinal large B-cell lymphoma tends to involve unusual extranodal sites such as the kidneys, adrenals, gastrointestinal tract and ovaries at the time of relapse/progression, [14][15][16] but also in ~7% of the patients at diagnosis. 14 CNSR had been consistently reported prior to the introduction of rituximab.…”

Section: Introductionmentioning

confidence: 99%

“…13 Primary mediastinal large B-cell lymphoma tends to involve unusual extranodal sites such as the kidneys, adrenals, gastrointestinal tract and ovaries at the time of relapse/progression, [14][15][16] but also in ~7% of the patients at diagnosis. 14 CNSR had been consistently reported prior to the introduction of rituximab. 15 The incidence in the rituximab era has been estimated to 2.3%-3.8% in four patient series, 11,[17][18][19] thus remaining questionable whether it is reduced by the addition of rituximab.…”

Section: Introductionmentioning

confidence: 99%

Incidence and risk factors for central nervous system relapse in patients with primary mediastinal large B‐cell lymphoma in the rituximab era

Panitsas

Mellios

Apostolidis

et al. 2022

Hematological Oncology

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Central nervous system (CNS) involvement is rare in primary mediastinal large B‐cell lymphoma (PMLBCL). We aimed to evaluate the incidence of CNS relapse as first treatment failure event and the effect of the induction chemotherapy regimen, central nervous system ‐ international prognostic index (CNS‐IPI) and other clinical and laboratory variables on the risk of CNS relapse in 564 PMLBCL patients treated with immunochemotherapy. Only 17 patients (3.0%) received CNS prophylaxis. During a 55‐month median follow‐up only 8 patients experienced CNS relapse as first event, always isolated. The 2‐year cumulative incidence of CNS relapse (CI‐CNSR) was 1.47% and remained unchanged thereafter. The CI‐CNSR was not affected by the chemotherapy regimen (R‐CHOP or R‐da‐EPOCH). None of the established International Prognostic Index factors for aggressive lymphomas predicted CNS relapse in PMLBCL. The 2‐year CI‐CNSR in patients with versus without kidney involvement was 13.3% versus 0.96% (p < 0.001); 14.3% versus 1.13% with versus without adrenal involvement (p < 0.001); and 10.2% versus 0.97% with versus without either kidney or adrenal involvement. CNS‐IPI was also predictive (2‐year CI‐CNSR in high‐risk vs. intermediate/low‐risk: 10.37% vs. 0.84%, p < 0.001). However, this association may be driven mainly by kidney and/or adrenal involvement. In conclusion, in PMLBCL, CNS relapse is rare and appears to be strongly associated with kidney and/or adrenal involvement.

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Subdiaphragmatic extranodal localizations at diagnosis of primary mediastinal large B-cell lymphoma: an impressive, rare presentation with no independent effect on prognosis

Cited by 4 publications

References 13 publications

Identification of Very Low-Risk Subgroups of Patients with Primary Mediastinal Large B-Cell Lymphoma Treated with R-CHOP

Identification of Very Low-Risk Subgroups of Patients with Primary Mediastinal Large B-Cell Lymphoma Treated with R-CHOP

Symptomatic ovarian involvement as the initial presentation of primary mediastinal large b-cell lymphoma

Incidence and risk factors for central nervous system relapse in patients with primary mediastinal large B‐cell lymphoma in the rituximab era

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