Concordant but not discordant bone marrow involvement in diffuse large B-cell lymphoma predicts a poor clinical outcome independent of the International Prognostic Index

被引:95
作者
Chung, Randy
Lai, Raymond
Wei, Peter
Lee, Jason
Hanson, John
Belch, Andrew R.
Turner, A. Robert
Reiman, Tony [1 ]
机构
[1] Univ Alberta, Dept Med Oncol, Edmonton, AB, Canada
[2] Univ Alberta, Dept Pathol, Edmonton, AB, Canada
[3] Univ Alberta, Cross Canc Inst, Edmonton, AB, Canada
[4] Univ Alberta, Fac Med & Dent, Edmonton, AB T6G 2M7, Canada
关键词
D O I
10.1182/blood-2007-01-070300
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
In diffuse large B-cell lymphoma (DLBCL), previous studies have suggested that, while concordant bone marrow (BM) involvement confers a poor prognosis, discordant BM involvement does not. Whether this correlation is independent of the non-Hodgkin lymphoma International Prognostic Index (IPI) was previously unknown. We reviewed all DLBCL case histories from 1986 to 1997 at our center with complete staging, IPI data, and follow-up. A total of 55 (11.2%) of 489 patients had BM involvement, including 29 with concordant involvement and 26 with discordant involvement. The 55 patients with BM involvement had a poor prognosis compared with the uninvolved BM group (5-year overall'survival [OS], 34.5% versus 46.9%; log-rank P =.019). However, concordant involvement portended a very poor prognosis (5-year CS, 10.3%; P <.001), whereas discordant involvement did not (5-year OS, 61.5%, P value nonsignificant). Compared with the discordant subset, the concordant subset patients were older, had a higher serum lactate dehydrogenase level, and a significantly higher IPI. However, the poor survival associated with concordant BM involvement was independent of the IPI score (P=.002, Cox regression). We conclude that in patients with DLBCL, concordant but not discordant BM involvement confers a very poor clinical outcome. Furthermore, concordant BM involvement is an independent adverse prognostic factor.
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页码:1278 / 1282
页数:5
相关论文
共 11 条
[1]   Distinct types of diffuse large B-cell lymphoma identified by gene expression profiling [J].
Alizadeh, AA ;
Eisen, MB ;
Davis, RE ;
Ma, C ;
Lossos, IS ;
Rosenwald, A ;
Boldrick, JG ;
Sabet, H ;
Tran, T ;
Yu, X ;
Powell, JI ;
Yang, LM ;
Marti, GE ;
Moore, T ;
Hudson, J ;
Lu, LS ;
Lewis, DB ;
Tibshirani, R ;
Sherlock, G ;
Chan, WC ;
Greiner, TC ;
Weisenburger, DD ;
Armitage, JO ;
Warnke, R ;
Levy, R ;
Wilson, W ;
Grever, MR ;
Byrd, JC ;
Botstein, D ;
Brown, PO ;
Staudt, LM .
NATURE, 2000, 403 (6769) :503-511
[2]  
BRUNNING RD, 1993, ATLAS TUMOR PATHOL, P369
[3]   The prognostic impact of bone marrow involvement in patients with diffuse large cell lymphoma varies according to the degree of infiltration and presence of discordant marrow involvement [J].
Campbell, J ;
Seymour, JF ;
Matthews, J ;
Wolf, M ;
Stone, J ;
Juneja, S .
EUROPEAN JOURNAL OF HAEMATOLOGY, 2006, 76 (06) :473-480
[4]   CHOP chemotherapy plus rituximab compared with CHOP alone in elderly patients with diffuse large-B-cell lymphoma. [J].
Coiffier, B ;
Lepage, E ;
Brière, J ;
Herbrecht, R ;
Tilly, H ;
Bouabdallah, R ;
Morel, P ;
Van den Neste, E ;
Salles, G ;
Gaulard, P ;
Reyes, F ;
Gisselbrecht, C .
NEW ENGLAND JOURNAL OF MEDICINE, 2002, 346 (04) :235-242
[5]   BONE-MARROW INVOLVEMENT BY NON-HODGKINS-LYMPHOMA - THE CLINICAL-SIGNIFICANCE OF MORPHOLOGICAL DISCORDANCE BETWEEN THE LYMPH-NODE AND BONE-MARROW [J].
CONLAN, MG ;
BAST, M ;
ARMITAGE, JO ;
WEISENBURGER, DD .
JOURNAL OF CLINICAL ONCOLOGY, 1990, 8 (07) :1163-1172
[6]   BONE-MARROW INVOLVEMENT IN LARGE-CELL LYMPHOMA - PROGNOSTIC IMPLICATIONS OF DISCORDANT DISEASE [J].
HODGES, GF ;
LENHARDT, TM ;
COTELINGAM, JD .
AMERICAN JOURNAL OF CLINICAL PATHOLOGY, 1994, 101 (03) :305-311
[7]  
Kremer M, 2003, LAB INVEST, V83, P107
[8]   DISCORDANT BONE-MARROW INVOLVEMENT IN DIFFUSE LARGE-CELL LYMPHOMA - A DISTINCT CLINICAL-PATHOLOGICAL ENTITY ASSOCIATED WITH A CONTINUOUS RISK OF RELAPSE [J].
ROBERTSON, LE ;
REDMAN, JR ;
BUTLER, JJ ;
OSBORNE, BM ;
VELASQUEZ, WS ;
MCLAUGHLIN, P ;
SWAN, F ;
RODRIGUEZ, MA ;
HAGEMEISTER, FB ;
FULLER, LM ;
CABANILLAS, F .
JOURNAL OF CLINICAL ONCOLOGY, 1991, 9 (02) :236-242
[9]   The use of molecular profiling to predict survival after chemotherapy for diffuse large-B-cell lymphoma [J].
Rosenwald, A ;
Wright, G ;
Chan, WC ;
Connors, JM ;
Campo, E ;
Fisher, RI ;
Gascoyne, RD ;
Muller-Hermelink, HK ;
Smeland, EB ;
Staudt, LM .
NEW ENGLAND JOURNAL OF MEDICINE, 2002, 346 (25) :1937-1947
[10]   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