Retrospective analysis of primary gastric diffuse large B cell lymphoma in the rituximab era: a multicenter study of 95 patients in Japan
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Tsutomu Tanaka & Kazuyuki Shimada & Kazuhito Yamamoto & Yoshiki Hirooka & Yasumasa Niwa & Isamu Sugiura & Kunio Kitamura & Hiroshi Kosugi & Tomohiro K
- چاپ و سال / کشور: 2011
Description
Primary gastric diffuse large B cell lymphoma (PG-DLBCL) is common subtype of extranodal non- Hodgkin lymphoma. The optimal treatment strategy for PG-DLBCL in the rituximab era still remains unknown. To evaluate clinical outcomes of PG-DLBCL in the rituximab era, we conducted a retrospective, multicenter analysis of 95 patients with PG-DLBCL. In 58 patients with localized disease, 3-year progression-free survival (PFS) and overall survival (OS) were 91% and 91% for patients with six cycles of rituximab plus CHOP (RCHOP) and 92% and 95% for patients with three to four cycles of R-CHOP plus radiotherapy (Log-rank test, P=0.595 and P=0.278, respectively). In 37 patients with advanced disease, 3-year PFS and 3-year OS were 43% and 64% for patients with R-CHOP chemotherapy with or without radiotherapy. On multivariate analysis, advanced stage and elevated serum LDH levels were independent predictors of survival in patients with PGDLBCL. One patient with localized disease relapsed in lymph node, and eight patients with advanced disease relapsed in lymph node (n=3), stomach (n=2), central nervous system (CNS; n=2), and duodenum (n=1). Intriguingly, CNS relapse developed within 6 months after initial series of treatment (4.9 and 5.8 months, respectively), and stomach relapse developed in later phase (27.2 and 32.9 months, respectively). Clinical outcomes of PGDLBCL were extremely favorable for localized-stage patients in the rituximab era, although these might be poor for advanced-stage patients even in the rituximab era. Further prospective analyses are warranted.
Ann Hematol DOI 10.1007/s00277-011-1306-0 Received: 18 February 2011 / Accepted: 26 July 2011
