Analysis of clinical characteristics and outcome of patients with previously untreated diffuse large B-cell lymphoma and renal involvement in the rituximab era

被引：10

作者：

Lehners, Nicola ^{[1
]}

Kraemer, Isabelle ^{[1
]}

Schwarzbich, Mark-Alexander ^{[2
]}

Ho, Anthony D. ^{[1
]}

Witzens-Harig, Mathias ^{[1
]}

机构：

[1] Heidelberg Univ, Dept Hematol & Oncol, Neuenheimer Feld 410, D-69120 Heidelberg, Germany

[2] Queen Mary Univ London, Barts Canc Inst, London, England

来源：

LEUKEMIA & LYMPHOMA | 2016年 / 57卷 / 11期

关键词：

chemotherapeutic approaches; lymphoma and Hodgkin disease; prognostication; NERVOUS-SYSTEM RELAPSE; NON-HODGKINS-LYMPHOMA; MABTHERA INTERNATIONAL TRIAL; RANDOMIZED CONTROLLED-TRIAL; RISK-FACTORS; ELDERLY-PATIENTS; AGGRESSIVE LYMPHOMAS; CNS PROPHYLAXIS; PLUS RITUXIMAB; PHASE-3; TRIAL;

D O I：

10.3109/10428194.2016.1157869

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Renal involvement in patients with lymphoma is rare but associated with poor prognosis. We analyzed characteristics and outcome of 22 patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL) and renal involvement treated with a rituximab-containing regimen in curative intent. The majority of patients presented in advanced disease, 86% were Ann Arbor stage >= III and had an IPI score >= 3. Renal impairment was present in 32%. Outcome was poor with three-year progression-free survival (PFS) 44% and three-year overall survival (OS) 52% and significantly worse compared to DLBCL without renal involvement (p < 0.01). Patients with high risk IPI had a significantly inferior prognosis compared to intermediate-risk IPI (three-year OS 0% vs. 75%, p = 0.01) as did those with renal impairment. A high rate of central nervous system (CNS) relapse (8/22) was observed. Intravenous high-dose methotrexate and intrathecal therapy showed a trend toward prolonged time to CNS relapse. Implementation of CNS prophylaxis might therefore be considered in these high-risk patients.

引用

页码：2619 / 2625

页数：7

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