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Matched-pair analysis comparing the outcomes of primary breast and nodal diffuse large B-cell lymphoma in patients treated with rituximab plus chemotherapy

Authors
 Ho-Young Yhim  ;  Jin Seok Kim  ;  Hye Jin Kang  ;  Seok Jin Kim  ;  Won Seog Kim  ;  Chul Won Choi  ;  Hyeon Seok Eom  ;  Jeong-A. Kim  ;  Jae Hoon Lee  ;  Jong Ho Won  ;  Hyeok Shim  ;  Jooryung Huh  ;  Dae-Ho Lee  ;  Cheolwon Suh  ;  Jae-Yong Kwak 
Citation
 INTERNATIONAL JOURNAL OF CANCER, Vol.131(1) : 235-243, 2012 
Journal Title
 INTERNATIONAL JOURNAL OF CANCER 
ISSN
 0020-7136 
Issue Date
2012
MeSH
Adult ; Aged ; Aged, 80 and over ; Antibodies, Monoclonal, Murine-Derived/therapeutic use* ; Antineoplastic Agents/therapeutic use* ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Breast Neoplasms/drug therapy* ; Breast Neoplasms/mortality ; Breast Neoplasms/pathology ; Cyclophosphamide/therapeutic use ; Disease Progression ; Disease-Free Survival ; Doxorubicin/therapeutic use ; Female ; Humans ; Lymphoma, Large B-Cell, Diffuse/drug therapy* ; Lymphoma, Large B-Cell, Diffuse/mortality ; Lymphoma, Large B-Cell, Diffuse/pathology ; Matched-Pair Analysis ; Middle Aged ; Prednisone/therapeutic use ; Rituximab ; Survival Rate ; Treatment Outcome ; Vincristine/therapeutic use ; Young Adult
Keywords
breast ; central nervous system ; diffuse large B-cell lymphoma ; rituximab
Abstract
Primary breast diffuse large B-cell lymphoma (DLBCL) is an extremely rare presentation of non-Hodgkin's lymphoma that has been associated with poorer clinical outcomes compared with nodal DLBCL in the pre-rituximab era. The aim of this study was to investigate the impact of rituximab on clinical outcomes in patients with primary breast DLBCL. Data from 25 female patients with primary breast DLBCL receiving rituximab plus chemotherapy were matched to 75 female patients (1:3) with nodal DLBCL by following five established prognostic factors (age, Ann Arbor stage, Eastern Cooperative Oncology Group performance status, serum lactate dehydrogenase level and B symptoms). Overall survival (OS) was similar between primary breast and nodal DLBCL groups (3-year OS rate, 82.2% vs. 90.7%, respectively; p = 0.345). In the analysis of immunohistochemically defined prognostic subgroups, 19 of 20 available cases in the primary breast DLBCL group displayed a non-germinal center (GC) phenotype. Compared with patterns of recurrence, extranodal progression in the breast or central nervous system (CNS) was significantly higher in the primary breast DLBCL group than in the nodal DLBCL group (p < 0.001). Additionally, the stage-modified International Prognostic Index was the only independent prognostic factor for OS in this population. This suggests that clinical outcomes of primary breast DLBCL might no longer be inferior to those of nodal DLBCL in the rituximab era, which might be associated with the intrinsic biologic characteristics of the non-GC phenotype. However, despite including rituximab, extranodal progression in the breast or CNS was problematic. This study was registered at www.clinicaltrials.gov as no. NCT01266668.
Full Text
http://onlinelibrary.wiley.com/doi/10.1002/ijc.26352/abstract
DOI
10.1002/ijc.26352
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jin Seok(김진석) ORCID logo https://orcid.org/0000-0001-8986-8436
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/158152
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