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Multicenter Study
. 2012 Aug 13:5:49.
doi: 10.1186/1756-8722-5-49.

Prognostic factors in primary diffuse large B-cell lymphoma of adrenal gland treated with rituximab-CHOP chemotherapy from the Consortium for Improving Survival of Lymphoma (CISL)

Yu Ri Kim  1 , Jin Seok Kim, Yoo Hong Min, Dok Hyunyoon, Ho-Jin Shin, Yeung-Chul Mun, Yong Park, Young Rok Do, Seong Hyun Jeong, Joon Seong Park, Sung Yong Oh, Suee Lee, Eun Kyung Park, Joung-Soon Jang, Won-Sik Lee, Hwe-Won Lee, Hyeonseok Eom, Jae-Sook Ahn, Jae-Heon Jeong, Sun Kyung Baek, Seok Jin Kim, Won Seog Kim, Cheolwon Suh
Affiliations
Multicenter Study

Prognostic factors in primary diffuse large B-cell lymphoma of adrenal gland treated with rituximab-CHOP chemotherapy from the Consortium for Improving Survival of Lymphoma (CISL)

Yu Ri Kim et al. J Hematol Oncol. .

Abstract

Background: The objective of this study was to identify prognostic factors for survival in patients with primary diffuse large B-cell lymphoma (DLBCL) of the adrenal gland.

Methods: Thirty one patients diagnosed with primary adrenal DLBCL from 14 Korean institutions and treated with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone) were analyzed.

Results: Complete remission (CR) and overall response rate after R-CHOP chemotherapy were 54.8% and 87.0%. The 2-year estimates of overall survival (OS) and progression-free survival (PFS) were 68.3% and 51.1%. In patients achieving CR, significant prolongations of OS (P = 0.029) and PFS (P = 0.005) were observed. Ann Arbor stage had no influence on OS. There was no significant difference in OS between patients with unilateral involvement of adrenal gland and those with bilateral involvement. When staging was modified to include bilateral adrenal involvement as one extranodal site, early stage (I or II) significantly correlated with longer OS (P = 0.021) and PFS (P <0.001).

Conclusions: Contrary to prior reports, our data suggests that outcomes of primary adrenal DLBCL are encouraging using a regimen of R-CHOP, and that achieving CR after R-CHOP is predictive of survival. Likewise, our modified staging system may have prognostic value.

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Figures

Figure 1
Figure 1
Management flow chart according to the modified stage; CR, complete remission; PR, partial remission; PD, progressive disease; NE, not evaluable; RT, radiotherapy; ASCT, autologous stem cell transplantation.
Figure 2
Figure 2
Kaplan-Meier survival analysis of primary adrenal DLBCL treated with R-CHOP. Overall survival (A) and progression-free survival (B) of 31 patients with primary adrenal DLBCL. Overall survival (C) and progression-free survival (D) according to the response of R-CHOP.
Figure 3
Figure 3
Overall surival (A) and progression-free survival (B) according to the modified stage in primary adrenal DLBCL.
Figure 4
Figure 4
Overall surival (A) and progression-free survival (B) according to the modified IPI score using modified staging system.
See this image and copyright information in PMC

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