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

共 33 条

[21] Intensified chemotherapy with ACVBP plus rituximab versus standard CHOP plus rituximab for the treatment of diffuse large B-cell lymphoma (LNH03-2B): an open-label randomised phase 3 trial [J].

Recher, Christian ;

Coiffier, Bertrand ;

Haioun, Corinne ;

Molina, Thierry Jo ;

Ferme, Christophe ;

Casasnovas, Olivier ;

Thieblemont, Catherine ;

Bosly, Andre ;

Laurent, Guy ;

Morschhauser, Franck ;

Ghesquieres, Herve ;

Jardin, Fabrice ;

Bologna, Serge ;

Fruchart, Christophe ;

Corront, Bernadette ;

Gabarre, Jean ;

Bonnet, Christophe ;

Janvier, Maud ;

Canioni, Danielle ;

Jais, Jean-Philippe ;

Salles, Gilles ;

Tilly, Herve .

LANCET, 2011, 378 (9806) :1858-1867

[22] RENAL INVOLVEMENT IN PATIENTS WITH NON-HODGKINS-LYMPHOMA - CLINICAL AND PATHOLOGICAL FEATURES IN 23 CASES [J].

RICHARDS, MA ;

MOOTOOSAMY, I ;

REZNEK, RH ;

WEBB, JAW ;

LISTER, TA .

HEMATOLOGICAL ONCOLOGY, 1990, 8 (02) :105-110

[23]

Savage KJ, 2014, BLOOD, V124, P394, DOI [10.1182/BLOOD.V124.21.394.394, DOI 10.1182/BLOOD.V124.21.394.394]

[24] CNS disease in younger patients with aggressive B-cell lymphoma: an analysis of patients treated on the Mabthera International Trial and trials of the German High-Grade Non-Hodgkin Lymphoma Study Group [J].

Schmitz, N. ;

Zeynalova, S. ;

Glass, B. ;

Kaiser, U. ;

Cavallin-Stahl, E. ;

Wolf, M. ;

Haenel, M. ;

Loeffler, M. ;

Truemper, L. ;

Pfreundschuh, M. .

ANNALS OF ONCOLOGY, 2012, 23 (05) :1267-1273

[25]

Schmitz N, 2013, HEMATOL ONCOL, V31

[26] A PREDICTIVE MODEL FOR AGGRESSIVE NON-HODGKINS-LYMPHOMA [J].

SHIPP, MA ;

HARRINGTON, DP ;

ANDERSON, JR ;

ARMITAGE, JO ;

BONADONNA, G ;

BRITTINGER, G ;

CABANILLAS, F ;

CANELLOS, GP ;

COIFFIER, B ;

CONNORS, JM ;

COWAN, RA ;

CROWTHER, D ;

DAHLBERG, S ;

ENGELHARD, M ;

FISHER, RI ;

GISSELBRECHT, C ;

HORNING, SJ ;

LEPAGE, E ;

LISTER, TA ;

MEERWALDT, JH ;

MONTSERRAT, E ;

NISSEN, NI ;

OKEN, MM ;

PETERSON, BA ;

TONDINI, C ;

VELASQUEZ, WA ;

YEAP, BY .

NEW ENGLAND JOURNAL OF MEDICINE, 1993, 329 (14) :987-994

[27] Central nervous system (CNS) relapse in diffuse large B cell lymphoma (DLBCL): pre- and post-rituximab [J].

Tai, W. M. ;

Chung, J. ;

Tang, P. L. ;

Koo, Y. X. ;

Hou, X. ;

Tay, K. W. ;

Quek, R. ;

Tao, M. ;

Lim, S. T. .

ANNALS OF HEMATOLOGY, 2011, 90 (07) :809-818

[28] Prognostic impact of extranodal involvement in diffuse large B-cell lymphoma in the rituximab era [J].

Takahashi, Hiroyuki ;

Tomita, Naoto ;

Yokoyama, Masahiro ;

Tsunoda, Saburo ;

Yano, Takahiro ;

Murayama, Kayoko ;

Hashimoto, Chizuko ;

Tamura, Kazuo ;

Sato, Kazuya ;

Ishigatsubo, Yoshiaki .

CANCER, 2012, 118 (17) :4166-4172

[29] Intrathecal methotrexate prophylaxis and central nervous system relapse in patients with diff use large B-cell lymphoma following rituximab plus cyclophosphamide, doxorubicin, vincristine and prednisone [J].

Tomita, Naoto ;

Takasaki, Hirotaka ;

Ishiyama, Yasufumi ;

Kishimoto, Kumiko ;

Ishibashi, Daisuke ;

Koyama, Satoshi ;

Ishii, Yoshimi ;

Takahashi, Hiroyuki ;

Numata, Ayumi ;

Watanabe, Reina ;

Tachibana, Takayoshi ;

Ohshima, Rika ;

Hagihara, Maki ;

Hashimoto, Chizuko ;

Takemura, Sachiya ;

Taguchi, Jun ;

Fujimaki, Katsumichi ;

Sakai, Rika ;

Motomura, Shigeki ;

Ishigatsubo, Yoshiaki .

LEUKEMIA & LYMPHOMA, 2015, 56 (03) :725-729

[30] Incidence and risk factors for central nervous system relapse in patients with diffuse large B-cell lymphoma: the impact of the addition of rituximab to CHOP chemotherapy [J].

Villa, D. ;

Connors, J. M. ;

Shenkier, T. N. ;

Gascoyne, R. D. ;

Sehn, L. H. ;

Savage, K. J. .

ANNALS OF ONCOLOGY, 2010, 21 (05) :1046-1052

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