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Clinical impact of bulky mass in the patient with primary extranodal diffuse large B cell lymphoma treated with R-CHOP therapy

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Abstract

Although numerous studies about primary extranodal diffuse large B cell lymphoma (DLBCL) were reported sporadically, the literature of clinical value of immunophenotype and bulky diameter in rituximab era is limited. Ninety-six patients with primary extranodal DLBCL receiving R-CHOP therapy were analyzed to evaluate whether immunophenotype and size of bulky disease are significantly important. The International Prognostic Index was still an important prognostic factor for progression-free survival (PFS) and overall survival (OS; p = 0.003, p = 0.027). Difference of survival between germinal center (GC) type and non-GC type was not different (PFS: p = 0.192; OS: p = 0.197). In two separated groups according to extranodal maximum tumor diameter (EN-MTD) 7.5 cm as cutoff value for survival, the group of EN-MTD ≥7.5 cm had lower PFS and OS than <7.5 cm (PFS: p = 0.001; OS: p = 0.008). In four divided subgroups according to EN-MTD combined with immunophenotype, the subgroup of non-GC type with EN-MTD ≥ 7.5 cm had lower PFS and OS compared with the other subgroups (PFS: p < 0.001; OS: p = 0.008). Multivariate analysis revealed that non-GC with EN-MTD ≥ 7.5 cm was an independent prognostic parameter (PFS: HR = 5.407, 95%CI = 2.378–12.294, p < 0.001; OS: HR = 4.136, 95%CI = 1.721–9.941, p = 0.002). Bulky primary extranodal DLBCL would be associated with unfavorable outcome especially in non-GC type.

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Acknowledgement

This study was supported by a grant from the National R&D Program for Cancer Control, Minister for Health, Welfare and Family Affairs, Republic of Korea (0920050).

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Authors and Affiliations

  1. Department of Hematology-Oncology, Busan National Cancer Center, Pusan National University Hospital Medical Research Institute, Busan, South Korea

    Moo-Kon Song, Joo-Seop Chung, Seung-Geun Kim, Young-Mi Seol, Ho-Jin Shin, Young-Jin Choi & Goon-Jae Cho

  2. Department of Hematology–Oncology, School of Medicine, Dong-A University Medical Center, Busan, South Korea

    Oh Sung-Yong

  3. Department of Hematology–Oncology, School of Medicine, Gyeongsang National University Hospital, Jinju, South Korea

    Gyeong-Won Lee

  4. Department of Pathology, Pusan National University Hospital, Busan, South Korea

    Dong-Hoon Shin

  5. Department of Statistics, Pusan National University, Busan, South Korea

    Eun-Young Yun

  6. Department of Hematology–Oncology, School of Medicine, Pusan National University, 1-10 Ami-dong, Seo-gu, Busan, 602-739, Republic of Korea

    Joo-Seop Chung

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  1. Moo-Kon Song
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Correspondence to Joo-Seop Chung.

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Song, MK., Chung, JS., Sung-Yong, O. et al. Clinical impact of bulky mass in the patient with primary extranodal diffuse large B cell lymphoma treated with R-CHOP therapy. Ann Hematol 89, 985–991 (2010). https://doi.org/10.1007/s00277-010-0964-7

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  • DOI: https://doi.org/10.1007/s00277-010-0964-7

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