Primary extra‑nodal diffuse large B‑cell lymphoma: A prognostic analysis of 141 patients

Shen,Haorui; Wei,Zhang; Zhou,Daobin; Zhang,Yan; Han,Xiao; Wang,Wei; Zhang,Lu; Yang,Chen; Feng,Jun

doi:10.3892/ol.2018.8803

Primary extra‑nodal diffuse large B‑cell lymphoma: A prognostic analysis of 141 patients

Authors:
- Haorui Shen
- Zhang Wei
- Daobin Zhou
- Yan Zhang
- Xiao Han
- Wei Wang
- Lu Zhang
- Chen Yang
- Jun Feng
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Affiliations: Department of Hematology, Peking Union Medical College Hospital, Beijing 100730, P.R. China
Published online on: May 24, 2018 https://doi.org/10.3892/ol.2018.8803
Pages: 1602-1614
Copyright: © Shen et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Diffuse large B‑cell lymphoma (DLBCL) is the most common subtype of lymphoma. Approximately 40% of DBLCL originates from extra‑nodal sites, but the diversity of clinical presentations and the genetic and molecular alterations indicate that extra‑nodal DLBCLs may be distinct disease entities. The aim of the present study was to highlight the various aspects of primary extra‑nodal DLBCL (PE‑DLBCL) based on a single center cohort. The data from 141 patients with PE‑DLBCL treated at Peking Union Medical College Hospital were retrospectively evaluated. The primary extra‑nodal sites involved were the gastrointestinal tract (n=42), central nervous system (CNS; n=38), breast (n=19), adrenal gland (n=15), female genital system (FGS; n=12), thyroid (n=8) and bone (n=7). The median overall survival rate was 28 months (range, 1‑116). Multivariate analysis demonstrated that an International Prognostic Index (IPI) ≤2 (P=0.049), complete remission (CR) achieved following first‑line therapy (P=0.001) and chemotherapy combined with rituximab (P<0.001) were positive prognostic factors. Patients with DLBCL with primary adrenal gland or female genital system (FGS) involvement exhibited a significantly higher risk of CNS recurrence (P<0.05). Rituximab treatment may have reduced the likelihood of CNS recurrence (P=0.005), whereas prophylaxis with intrathecal injection alone was not sufficient for prevention (P>0.05). In conclusion, IPI >2 and the lack of a CR following first‑line therapy were independent prognostic risk factors for PE‑DLBCL. Patients with primary adrenal gland or FGS involvement exhibited a higher risk of CNS relapse. Rituximab had a positive impact on the survival of patients with PE‑DLBCL, also reducing the likelihood of CNS relapse.

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