Clinicopathological study on peripheral T-cell non-Hodgkin lymphoma with bone marrow involvement: a retrospective analysis from China

Abstract Purpose Fluorine-18 fluorodeoxyglucose positron emission tomography combined with computed tomography (FDG PET/CT) is the standard for staging aggressive non-Hodgkin lymphoma (NHL). Limited data from prospective studies is available to determine whether initial staging by FDG PET/CT provides treatment-relevant information of bone marrow (BM) involvement (BMI) and thus could spare BM biopsy (BMB). Methods Patients from PETAL (NCT00554164) and OPTIMAL>60 (NCT01478542) with aggressive B-cell NHL initially staged by FDG PET/CT and BMB were included in this pooled analysis. The reference standard to confirm BMI included a positive BMB and/or FDG PET/CT confirmed by targeted biopsy, complementary imaging (CT or magnetic resonance imaging), or concurrent disappearance of focal FDG-avid BM lesions with other lymphoma manifestations during immunochemotherapy. Results Among 930 patients, BMI was detected by BMB in 85 (prevalence 9%) and by FDG PET/CT in 185 (20%) cases, for a total of 221 cases (24%). All 185 PET-positive cases were true positive, and 709 of 745 PET-negative cases were true negative. For BMB and FDG PET/CT, sensitivity was 38% (95% confidence interval [CI]: 32–45%) and 84% (CI: 78–88%), specificity 100% (CI: 99–100%) and 100% (CI: 99–100%), positive predictive value 100% (CI: 96–100%) and 100% (CI: 98–100%), and negative predictive value 84% (CI: 81–86%) and 95% (CI: 93–97%), respectively. In all of the 36 PET-negative cases with confirmed BMI patients had other adverse factors according to IPI that precluded a change of standard treatment. Thus, the BMB would not have influenced the patient management. Conclusion In patients with aggressive B-cell NHL, routine BMB provides no critical staging information compared to FDG PET/CT and could therefore be omitted. Trial registration NCT00554164 and NCT01478542

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Haploidentical hematopoietic stem-cell transplantation for non-Hodgkin lymphoma with bone marrow involvement

Leukemia & Lymphoma ◽

10.1080/10428190903156745 ◽

2009 ◽

Vol 50 (9) ◽

pp. 1488-1493 ◽

Cited By ~ 10

Author(s):

Heng-Xiang Wang ◽

Hong-Min Yan ◽

Jing Liu ◽

Lian-Ning Duan ◽

Zhi-Dong Wang ◽

...

Keyword(s):

Bone Marrow ◽

Stem Cell ◽

Hematopoietic Stem Cell Transplantation ◽

Stem Cell Transplantation ◽

Hodgkin Lymphoma ◽

Cell Transplantation ◽

Hematopoietic Stem Cell ◽

Bone Marrow Involvement ◽

Hematopoietic Stem ◽

Non Hodgkin Lymphoma

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Clinical Outcome of 119 Children with Non-Hodgkin Lymphoma Treated in a Single Center in China

Blood ◽

10.1182/blood.v112.11.5299.5299 ◽

2008 ◽

Vol 112 (11) ◽

pp. 5299-5299

Author(s):

Yonghong Zhang ◽

Ling Jin ◽

Jing Yang ◽

Yanlong Duan ◽

Chunjv Zhou ◽

...

Keyword(s):

Bone Marrow ◽

T Cell ◽

B Cell ◽

Hodgkin Lymphoma ◽

Nk Cell ◽

Cell Lymphoma ◽

B Cell Lymphoma ◽

Lymphoblastic Lymphoma ◽

Non Hodgkin Lymphoma ◽

Pathologic Classification

Abstract One hundred and nineteen children with non-Hodgkin lymphoma were treated between February 2003 and December 2006 in Beijing Children’s Hospital on BCH-2003-NHL protocol. The diagnosis was made by histopathology of the biopsied tissue and/or bone marrow, and disease was classified according to WHO-2001 pathologic classification. We applied modified LMB89 protocol to cases with B-cell lymphoma; modified BFM90-ALL protocol for lymphoblastic lymphoma and cutaneous T-cell/NK cell lymphoma; and modified BFM90-ALCL protocol for anaplastic large-cell lymphoma (ALCL). There were 50 cases (42%) of B cell lymphoma including 32 cases of Burkitt¡’s lymphoma, 10 cases of Burkitt-like lymphoma and 8 cases of diffuse large B cell lymphoma; 44 cases (37%) of lymphoblastic lymphoma; 19 cases (16%) of ALCL; and 6 cases (5%) of cutaneous T-cell/NK cell lymphoma. The 85 boys and 34 girls (ratio, 2.5:1) ranged in age from 2 to 15 years (median, 7.8 years) at diagnosis. B cell lymphoma typically presented as abdomen mass and acute abdomen; nasopharynx and tonsil were also common sites of involvement. Lymphoblastic lymphoma generally presented with mediastinal mass and bone marrow involvement. There was no typical presentation for ALCL. According to the St. Jude staging system, 19 cases had stage I–II, and 94 cases stage III–VI diseases (exclude 6 cases of cutaneous T-cell/NK cell lymphoma). Seven cases had CNS involvement and 25 cases involved bone marrow. The treatment duration was 2 to 8 months for B-cell lymphoma, 2.5 to 3 years for lymphoblastic lymphoma and 1 to 1.5 years for ALCL. The follow-up rate was 100% and median observation period was 23 months. The overall survival (OS) at 3 years was 90.7% and the 3-year event-free survival (EFS) estimate was 82.3%. For B-cell lymphoma, 3-year OS was 88.68% and 3-year EFS was 81.8%. For lymphoblastoma lymphoma, the rates were 89.3% and 69.4%, respectively. All cases of ALCL are alive with on undergoing treatment for relapse. Patients with ALCL achieved the best 3-year OS (100%) and had 3-year EFS of 94.2%. Grade 3 or 4 bone marrow suppression occurred in 97.5% of patients with B-cell lymphoma, 100% of those with lymphoblastic lymphoma and 89.5% of cases with ALCL. As of to date, 11 patients have died, the causes of death include infection (n=4), abandonment of therapy (n=6) and relapse (n=1). Univarate analysis showed that stage IV disease, failure to achieve complete remission after 3 months of treatment, and bulky mass are were associated with poor prognosis £all P values <0.05£©. In summary, we have achieved excellent treatment results using modified international protocols. Infection and financial problem remained the main reasons of treatment failure.

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Significance of Clinical Factors As Prognostic Indicators for Mature T-Cell Non-Hodgkin Lymphoma Patients: A Retrospective Analysis of Chinese Cases

Blood ◽

10.1182/blood.v120.21.5093.5093 ◽

2012 ◽

Vol 120 (21) ◽

pp. 5093-5093

Author(s):

Wanzhuo Xie ◽

Keyue Hu ◽

Fan Xu ◽

De Zhou ◽

Weijia Huang ◽

...

Keyword(s):

T Cell ◽

Hodgkin Lymphoma ◽

Conflicts Of Interest ◽

Bone Marrow Involvement ◽

International Prognostic Index ◽

Eastern Cooperative Oncology Group ◽

Intensive Chemotherapy ◽

Clinical Factors ◽

Non Hodgkin Lymphoma ◽

Ann Arbor

Abstract Abstract 5093 Objectives: To retrospectively analyze the significance of different clinical factors for predicting the prognosis of mature T-cell non-Hodgkin lymphoma (MTCL) patients. Methods: Two hundred and fifty-two MTCL patients admitted from 2005 to 2011 into the First Affiliated Hospital of the Zhejiang University were retrospectively reviewed. All diagnoses were confirmed by histopathological hematoxylin and eosin (HE) staining and prognostic values of β2-microglobulin (β2-MG) levels, lactate dehydrogenase (LDH) levels, B symptoms, Ann Arbor stages, international prognostic index (IPI), Eastern Cooperative Oncology Group (ECOG) performance status, bone marrow involvement (BMI) and extra nodal involvement (ENI) for the overall survival (OS) were evaluated. Additionally, we compared the OS of patients treated with CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) and patients treated with an alternative intensive chemotherapy. Results: At a median follow-up of 23 months, the OS rate was 23. 8%. Our results revealed that the presence of B symptoms (P <0. 001), ECOG score≥2 (P <0. 001), BMI (P <0. 001), elevated LDH levels (P <0. 001), elevated β2-MG levels (P<0. 001), Ann Arbor stages III/IV (P=0. 007) and IPI ≥3 (P=0. 001) were factors for a poor OS prognosis and intensive chemotherapy showed a better OS outcome than CHOP treatment. Conclusion: Elevated LDH and β2-MG levels, B symptoms, Ann Arbor stage III/IV, BMI, high IPI indexes and ECOG scores predict an unfavorable prognosis of MTCL patients. When compared with the classical CHOP regimen, the intensive chemotherapy treatment can improve the prognosis of patients with MTCL. Disclosures: No relevant conflicts of interest to declare.

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