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Primary Mediastinal Large B-Cell Lymphoma: A Single-Institution Clinical Study in Japan

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Abstract

Several clinicopathologic studies of primary mediastinal large B-cell lymphoma (Med-DLBCL) have been reported from Western countries; however, only a few series of at most 10 cases are available in Japan.To further clarify the Med-DLBCL occurring in Japan, we analyzed the clinical features of 28 patients with Med-DLBCL diagnoses who were treated at the National Cancer Center Hospital between 1982 and 2002. The median age was 37 years (range, 18–80 years). The ages of 16 male patients ranged widely from 18 to 80 years, whereas the 12 female patients appeared to show a single age peak at 20 to 40 years. Only 13 patients (46%) achieved a complete response with initial treatments, mostly by CHOP-like regimens (cyclophosphamide, doxorubicin, vincristine [Oncovin], and prednisolone) followed by radiotherapy.The estimated 3-year overall and failure-free survival rates were 32% and 33%, respectively, indicating the relatively unfavorable prognosis of the patients in our series.The following factors were found to be significantly associated with shortened survival prospects: age >60 years, serum lactate dehydrogenase level greater than normal, performance status >1, and presence of bulky mediastinal mass. In conclusion, the clinical features of Japanese patients with Med-DLBCL may be different from those with the disease in Western countries. Because this investigation was a single-institution study with a limited number of patients, however, multicenter confirmatory studies are needed.

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References

  1. Harris NL, Jaffe ES, Stein H, et al. A revised European-American classification of lymphoid neoplasms: a proposal from the international lymphoma study group. Blood. 1994;84:1361–1392.

    CAS  PubMed  Google Scholar 

  2. Banks PM, Warnke RA. Mediastinal (thymic) large B-cell lymphoma. In: Jaffe ES, Harris NL, Stein H, Vardiman JW, eds. World Health Organization Classification of Tumours: Pathology & Genetics: Tumours of Haematopoietic and Lymphoid Tissues. Lyon, France: IARC Press; 2001:175–176.

    Google Scholar 

  3. Lazzarino M, Orlandi E, Paulli M, et al. Treatment outcome and prognostic factors for primary mediastinal (thymic) B-cell lymphoma: a multicenter study of 106 patients. J Clin Oncol. 1997;15:1646–1653.

    Article  PubMed  CAS  Google Scholar 

  4. Cazals-Hatem D, Lepage E, Brice P, et al. Primary mediastinal large B-cell lymphoma: a clinicopathologic study of 141 cases compared 916 nonmediastinal large B-cell lymphomas: a GELA (“Groupe d’Etude des lymphomas de I’Adulte”) study. Am J Surg Pathol. 1996;20:877–888.

    Article  PubMed  CAS  Google Scholar 

  5. Besien KV, Kelta M, Bahaguna P. Primary mediastinal B-cell lymphoma: a review of pathology and management. J Clin Oncol. 2001;19:1855–1864.

    Article  PubMed  Google Scholar 

  6. Falini B, Venturi S, Martelli M, et al. Mediastinal large B-cell lymphoma: clinical and immunohistologic findings in 18 patients treated with different third-generation regimens. Br J Haematol. 1995;89:780–789.

    Article  PubMed  CAS  Google Scholar 

  7. Zinzani PL, Martelli M, Bertini M, et al. Induction chemotherapy strategies for primary mediastinal large B-cell lymphoma with sclerosis: a retrospective multinational study on 426 previously untreated patients. Haematologica. 2002;87:1258–1264.

    PubMed  CAS  Google Scholar 

  8. Zinzani PL, Martelli M, Magagnoli M, et al. Treatment and clinical management of primary mediastinal large B-cell lymphoma with sclerosis: MACOP-B regimen and mediastinal radiotherapy monitored by (67) gallium scan in 50 patients. Blood. 1999;94:3289–3293.

    PubMed  CAS  Google Scholar 

  9. Bieri S, Roggero E, Zucca E, et al. Primary mediastinal large B-cell lymphoma (PMLCL): the need for prospective controlled clinical trials. Leuk Lymphoma. 1999;35:139–146.

    Article  PubMed  CAS  Google Scholar 

  10. Haioun C, Gaulard P, Roudot-Thoraval F, et al. Mediastinal diffuse large-cell lymphoma with sclerosis: a condition with a poor prognosis. Am J Clin Oncol. 1989;12:425–429.

    Article  PubMed  CAS  Google Scholar 

  11. Jacobson JO, Aisenberg AC, Lamarre L, et al. Mediastinal large cell lymphoma. an uncommon subset of adult lymphoma curable with combined modality therapy. Cancer. 1988;62:1893–1898.

    Article  PubMed  CAS  Google Scholar 

  12. Kirn D, Mauch P, Shaffer K, et al. Large-cell and immunoblastic lymphoma of the mediastinum: prognostic features and treatment outcome in 57 patients. J Clin Oncol. 1993;11:1336–1343.

    Article  PubMed  CAS  Google Scholar 

  13. Abou-Elella AA, Weisenburger DD, Vose JM, et al. Primary mediastinal large B-cell lymphoma: a clinicopathologic study of 43 patients from the Nebraska Lymphoma Study Group. J Clin Oncol. 1999;17:784–790.

    Article  PubMed  CAS  Google Scholar 

  14. Yonetani N, Kurata M, Nishikori M, et al. Primary mediastinal large B-cell lymphoma: a comparative study with nodular sclerosistype Hodgkin’s disease. Int J Hematol. 2001;74:178–185.

    Article  PubMed  CAS  Google Scholar 

  15. Nakagawa A, Nakamura S, Koshikawa T, et al. Clinicopathologic study of primary mediastinal non-lymphoblastic non-Hodgkin’s lymphomas among the Japanese. Acta Pathol Jpn. 1993;43:44–54.

    PubMed  CAS  Google Scholar 

  16. Itami J, Hara R, Komiyama T, et al. Role of radiation therapy in the management of primary mediastinal large B-cell lymphoma (PMLBL). Rad Med. 2002;20:311–318.

    Google Scholar 

  17. Rosenwald A, Wright G, Leroy K, et al. Molecular diagnosis of primary mediastinal B cell lymphoma identifies a clinically favorable subgroup of diffuse large B cell lymphoma related to Hodgkin lymphoma. J Exp Med. 2003;198:851–862.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  18. Savage KJ, Monti S, Kutok JL, et al. The molecular signature of mediastinal large B-cell lymphoma differs from that of other diffuse large B-cell lymphomas and shares features with classical Hodgkin lymphoma. Blood. 2003;102:3871–3879.

    Article  PubMed  CAS  Google Scholar 

  19. Lossos IS, Levy R. Diffuse large B-cell lymphoma: insights gained from gene expression profiling. Int J Hematol. 2003;77:321–329.

    Article  PubMed  CAS  Google Scholar 

  20. Kadin ME, Berard CW, Nanba K, Wakasa H. Lymphoproliferative diseases in Japan and Western countries: proceedings of the United States-Japan Seminar, September 6 and 7, 1982, in Seattle, Washington. Hum Pathol. 1983;14:745–772.

    Article  PubMed  CAS  Google Scholar 

  21. International Non-Hodgkin’s Lymphoma Prognostic Factors Project. A predictive model for aggressive non-Hodgkin’s lymphoma. N Engl J Med. 1993;329:987–994.

    Article  Google Scholar 

  22. Green FL, Page DL, Fleming ID, et al., eds. AJCC Cancer Staging Manual. 6th ed. New York, NY: Springer-Verlag; 2002:393–403.

    Book  Google Scholar 

  23. Carbone PP, Kaplan HS, Musshoff K, et al. Report of the committee on Hodgkin’s disease staging classification. Cancer Res. 1971;31:1860–1861.

    PubMed  CAS  Google Scholar 

  24. Oken MM, Creech RH, Tormey DC, et al. Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol. 1982;5:649–655.

    Article  PubMed  CAS  Google Scholar 

  25. Lister TA, Crowther D, Sutcliffe SB, et al. Report of committee convened to discuss the evaluation and staging of patients with Hodgkin’s disease: Cotswolds Meeting. J Clin Oncol. 1989;7:1630–1636.

    Article  PubMed  CAS  Google Scholar 

  26. Shimoyama M, Ota K, Kikuchi M, et al. Chemotherapeutic results and prognostic factors of patients with advanced non-Hodgkin’s lymphoma treated with VEPA or VEPA-M. J Clin Oncol. 1988;6:128–141.

    Article  PubMed  CAS  Google Scholar 

  27. Tobinai K, Shimoyama M, Minato K, et al. Japan Clinical Oncology Group phase II trial of second-generation “LSG4 protocol” in aggressive T- and B-lymphoma: a new predictive model for T- and B-lymphoma [abstract]. Proc Am Soc Clin Oncol. 1994;13:378.

    Google Scholar 

  28. Kinoshita T, Hotta T, Tobinai K, et al. Randomized phase III trial investigating survival benefit of dose-intensified multidrug combination chemotherapy (LSG9) for intermediateor high-grade non-Hodgkin’s lymphoma (NHL): Japan Clinical Oncology Group (JCOG) Study (JCOG9002) [abstract]. Proc Am Soc Clin Oncol. 2002;21:289a.

    Google Scholar 

  29. Lamarre L, Jacobson JO, Aisenberg AC, Harris NL. Primary large cell lymphoma of the mediastinum: a histologic and immunophenotypic study of 29 cases. Am J Surg Pathol. 1989;13:730–739.

    Article  PubMed  CAS  Google Scholar 

  30. Non-Hodgkin’s Lymphoma Classification Project. A clinical evaluation of the International Lymphoma Study Group classification of non-Hodgkin’s lymphoma. Blood. 1997;89:3909–3918.

    Google Scholar 

  31. Armitage JO, Weisenburger DD. New approach to classifying non-Hodgkin’s lymphomas: clinical features of the major histologic subtypes: Non-Hodgkin’s Lymphoma Classification Project. J Clin Oncol. 1998;16:2780–2795.

    Article  PubMed  CAS  Google Scholar 

  32. Anderson JR, Armitage JO, Weisenburger DD. Epidemiology of the non-Hodgkin’s lymphomas: distributions of the major subtypes differ by geographic locations. Ann Oncol. 1998;9:717–720.

    Article  PubMed  CAS  Google Scholar 

  33. Toh HC, Koh CH, Ang PT. Primary mediastinal large cell lymphoma in an aggressive and chemorefractory subtype in an Asian diffuse large cell lymphoma series. Med Pediatr Oncol. 1998;31:125.

    Article  PubMed  CAS  Google Scholar 

  34. Lymphoma Study Group of Japanese Pathologists. The World Health Organization classification of malignant lymphomas in Japan: incidence of recently recognized entities. Pathol Int. 2000;50:696–702.

    Article  Google Scholar 

  35. Klimo P, Connors JM. MACOP-B chemotherapy for the treatment of diffuse large-cell lymphoma. Ann Intern Med. 1985;102:596–602.

    Article  PubMed  CAS  Google Scholar 

  36. Sehn LH, Antin JH, Shulman LN, et al. Primary diffuse large B-cell lymphoma of the mediastinum: outcome following high-dose chemotherapy and autologous hematopoietic cell transplantation. Blood. 1998;91:717–723.

    PubMed  CAS  Google Scholar 

  37. Popat U, Przepiorka D, Champlin R, et al. High-dose chemotherapy for relapsed and refractory diffuse large B-cell lymphoma: mediastinal localization predicts a favorable prognosis. J Clin Oncol. 1998;16:63–69.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Hematology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, 104-0045, Tokyo, Japan

    Naohiro Sekiguchi, Junko Nishimoto, Kazuki Tanimoto, Shigeru Kusumoto, Yasushi Onishi, Takashi Watanabe, Yukio Kobayashi & Kensei Tobinai

  2. Thoracic Surgery, National Cancer Center Hospital, Tokyo, Japan

    Hisao Asamura

  3. Radiation Oncology, National Cancer Center Hospital, Tokyo, Japan

    Yoshikazu Kagami

  4. Clinical Laboratory Divisions, National Cancer Center Hospital, Tokyo, Japan

    Yoshihiro Matsuno

Authors
  1. Naohiro Sekiguchi
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  2. Junko Nishimoto
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  3. Kazuki Tanimoto
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  4. Shigeru Kusumoto
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  5. Yasushi Onishi
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  6. Takashi Watanabe
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  11. Kensei Tobinai
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Correspondence to Kensei Tobinai.

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Sekiguchi, N., Nishimoto, J., Tanimoto, K. et al. Primary Mediastinal Large B-Cell Lymphoma: A Single-Institution Clinical Study in Japan. Int J Hematol 79, 465–471 (2004). https://doi.org/10.1532/IJH97.03173

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  • DOI: https://doi.org/10.1532/IJH97.03173

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