Prognositc Inpact of Tumor-Infiltrating FOXP3 + Regulatory T Cells in DLBCL Treated with R-CHOP

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 1555-1555
Author(s):  
Naoe Goto ◽  
Hisashi Tsurumi ◽  
Yuhei Shibata ◽  
Ryoko Mabuchi ◽  
Nobuhiko Nakamura ◽  
...  
Keyword(s):  
T Cell ◽  
Conflicts Of Interest ◽  
Performance Status ◽  
Prognostic Significance ◽  
B Cell Lymphoma ◽  
High Serum ◽  
Cytotoxic T Cell ◽  
Serum Lactate Dehydrogenase ◽  
Poor Performance Status ◽  
Median Percentage

Abstract Abstract 1555 Background: Tumor-infiltrating immune cells perform important functions in host immune reaction against tumor cells including diffuse large B cell lymphoma (DLBCL). Recently, variable tumor-infiltrating cells were reported to give a influence for prognosis, for example, regulatory T cell (T reg), cytotoxic T cell, macrophage and mast cell etc. Among these microenvironmental cells, we focused on Treg cell, and we assessed the distribution and prognostic significance of these cells in DLBCL. The forkhead/winged helix transcription factor 3 (FOXP3) is a transcriptional factorshown to be the key control gene in the development and function of Tregs both in mice and humans. Patients and Methods: We examined samples from 94 patients (54 men and 40 women; median age, 70 years) at diagnosis who were prospectively enrolled between 2002 and 2008. All patients treated with R-CHOP(rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone). The pattern of FOXP3 protein expression was evaluated using immunehistochemistry in paraffin-embeded tissue samples. In addition, these samples were stained with antibodies for CD10, bcl-6 and MUM-1 via tissue microarray to classify into subgroups. Results: The median percentage of FOXP3+ cells was 91/mm2 (range 4–2100 /mm2). Patients with poor performance status (PS), and high serum lactate dehydrogenase (LDH) showed lower numbers of FOXP3+ cells. (PS; p= 0.014, LDH; p=0.0048) Patients with high counts of FOXP3+ cells (>90/mm2) have better prognosis than those of low counts (5 year (5-y) overall survival (OS); 72.1%, 49.7% p=0.024, respectively). Although no prognostic difference was observed between GCB type and non-GCB type (5-y OS: GCB 71.2%, non GCB 53.1%, p=0.12), low counts of FOXP3+ cell and non-GCB type patient was poorer prognosis than high counts and non GCB type. (low 5-y OS 31.2%, high 5-y OS 69.8% p=0.02). Conclusion: Increased count of FOXP3+ tumor-infiltrating cell might predict better prognosis of DLBCL. Disclosures: No relevant conflicts of interest to declare.

Prognositc Inpact of Tumor-Infiltrating Cells Especially CD163 Positive Macrophage in DLBCL Treated with R-CHOP

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 1594-1594
Author(s):  
Naoe Goto ◽  
Nobuhiro Kanemura ◽  
Hisashi Tsurumi ◽  
Nobuhiko Nakamura ◽  
Senji Kasahara ◽  
...  
Keyword(s):  
T Cell ◽  
Conflicts Of Interest ◽  
International Prognostic Index ◽  
Prognostic Significance ◽  
Prognostic Index ◽  
B Cell Lymphoma ◽  
Cytotoxic T Cell ◽  
High Count ◽  
Significant Difference ◽  
Infiltrating Cells

Abstract Abstract 1594 Background: Tumor-infiltrating immune cells perform important functions in host immune reaction against tumor cells including diffuse large B cell lymphoma (DLBCL). Recently, variable tumor-infiltrating cells were reported to give a influence for prognosis, for example, regulatory T cell (T reg), cytotoxic T cell, macrophage and mast cell etc. Among these microenvironmental cells, we focused on Treg, cytotoxic T and macrophage cell, and we assessed the distribution and prognostic significance of these cells in DLBCL. Patients and Methods: We examined samples from 124 patients with DLBCL (69 men and 55 women; median age, 70 years) at diagnosis who were prospectively enrolled between 2002 and 2008. All patients were treated with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone). FOXP3 protein expression as Treg cells, CD8 expression as cytotoxic T cells, and CD163 expression as activated macrophage cells were evaluated by using immunohistochemistry in paraffin-embeded tissue samples. Results: The median count of FOXP3+ cells was 15.2/mm2 (×400) (range 1– 350/mm2), the median of CD8+ cells was 72/mm2 (8−402) and the median of CD163+ cells was 24/mm2 (0−114). Patients with high count of FOXP3+ cells (>15/mm2) have better prognosis than those of low count (5 year (5-y) overall survival (OS); 72.1%, 49.7% p=0.024, respectively). No significant difference was observed for progression free survival (PFS) of FoxP3 expression. No significant difference was observed for OS and PFS of CD8 expression. Patients with low count of CD163+ cells (<15/mm2) have better prognoses than those of high count (5-y OS; 80.1%, 52.5% p=0.009, 5-y PFS: 84.3%, 42.9% p=0.0019, respectively). Multivariate analyses employing factors such as poor risk group of revised International Prognostic Index (R-IPI), non-GCB type of subtype and low counts of FoxP3, low count of CD8, and high count of CD163 demonstrated that CD163 and R-IPI for OS and PFS were independent prognostic factors (OS; CD163 odd's ratio: 2.56, p=0.038, R-IPI: 2.66, p=0.015, PFS; CD163: 2.73, p=0.03, R-IPI: 2.56, p= 0.012). Conclusion: The count of tumor-infiltrating cells especially CD163+ macrophage might predict prognosis of DLBCL treated with R-CHOP. Disclosures: No relevant conflicts of interest to declare.

Renal Failure in Multiple Myeloma: Incidence, Correlations and Prognostic Significance.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 5000-5000
Author(s):  
Vangelis Eleftherakis-Papaiakovou ◽  
Athanasios Anagnostopoulos ◽  
Aristotelis Bamias ◽  
Dimitra Gika ◽  
Argiris Symeonidis ◽  
...  
Keyword(s):  
Renal Failure ◽  
Performance Status ◽  
Prognostic Significance ◽  
Elevated Serum ◽  
Early Death ◽  
Poor Performance ◽  
High Serum ◽  
Poor Performance Status ◽  
Β2 Microglobulin ◽  
Bence Jones Proteinuria

Abstract Introduction: Renal failure (RF) is a common and severe complication of patients with multiple myeloma (MM). The purpose of our study was to assess the incidence of RF in a contemporary series of newly diagnosed patients with MM, its association with specific clinical and laboratory features and its impact on early death rate, on myeloma response and on patients survival. Patients and Methods: Between January 1995 and December 2004, 756 newly diagnosed symptomatic patients with MM were included in the database of the GMSG. Renal failure, was defined as a serum creatinine ≥2mg/dL at the time of diagnosis. The incidence of RF was correlated with multiple clinical and laboratory variables by univariate and Cox regression analysis. Results: The incidence of RF in this series of patients was 21%. This figure was similar to the incidence of RF (19%) in patients diagnosed during the preceding decade. Severe RF (serum creatinine ≥6mg/dL) occurred in 4% of patients. There was a significant association of renal failure with poor performance status (p=0.001), increased ISS stage (p&lt;0.001), elevated serum β2microglobulin (p&lt;0.001), hypercalcemia (p&lt;0.001), increased Bence Jones proteinuria (p&lt;0.001), high serum LDH (p&lt;0.002), low platelet count (p=0.004), low albumin (p=0.036) and light chain only on IgD myeloma (p&lt;0.001). Multivariate analysis showed that RF was independently associated only with ISS and Bence Jones proteinuria. Early death, within 2 months from treatment initiation, was observed in 10% of patients with RF and in 4% of patients without RF (p=0.2). At least partial response (EBMT criteria) was documented in 61% of patients without RF and in 55% of patients with RF (p=0.2). The median survival of patients with RF was 19.5 months versus 40.4 months for patients without RF (p&lt;0.001). Other variables associated with impaired survival by univariate analysis included poor performance status, thrombocytopenia, hypercalcemia, high serum LDH, advanced age and elevated serum β2 microglobulin. However, when multivariate analysis was performed the independent variables were poor performance status, thrombocytopenia, advanced age, high LDH and elevated serum β2 microglobulin but not high creatinine. The median survival of patients with ISS stage 2 and 3 without RF was 36 months and 22 months respectively compared to 19 months and 20 months for patients with RF (p=0.1 and 0.5 respectively). Conclusions: The incidence of RF remains significant and essentially unchanged in patients with MM diagnosed over the last 20 years. The presence of RF is associated with a trend for higher early death rate but with a similar response to primary therapy. Patients with RF have lower survival compared to patients without RF. The prognostic significance of RF is mainly attributed to its association with higher β2;microglobulin and Bence Jones proteinuria.

Elderly Very Poor Performance Status Patients with Aggressive B Cell Lymphomas Can Gain Long Term Remissions with Intensive Chemotherapy with Encouraging Response Rates and Overall Survival (OS).

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 2794-2794
Author(s):  
Stella J Bowcock ◽  
Vincenzo Fontana ◽  
Yvonne Noble ◽  
Susan Ward ◽  
Keith Winyard ◽  
...  
Keyword(s):  
B Cell ◽  
Conflicts Of Interest ◽  
Performance Status ◽  
Poor Performance ◽  
B Cell Lymphoma ◽  
Late Relapse ◽  
Poor Performance Status ◽  
Intensive Chemotherapy ◽  
B Cell Lymphomas ◽  
Curative Intent

Abstract Abstract 2794 Introduction Patients (pts) of older age, poor performance status (PS) and advanced stage with aggressive B cell lymphomas are regarded as poor prognosis and may receive no treatment, or palliative rather than curative chemotherapy. Studies suggest these pts may be undertreated and poor outcome may be partly related to undertreatment. Our unit has had a policy of offering treatment with curative intent to all pts presenting with aggressive B cell lymphomas, whatever their age or PS providing comorbidities allow. We reviewed the outcome of this policy. Methods All pts age≥70 years with diffuse large B cell lymphoma (DLBCL) or Burkitts lymphoma (BL) between 2000–2010 incl. were found from histology, chemotherapy and registry records. Poor PS pts were selected by including all who were inpatients during their 1st chemotherapy cycle, or if untreated, at diagnosis. If ECOG PS had not been prospectively recorded, ≥2 staff (from the 6 who were present throughout the 10 years) independently attributed status from memory and hospital notes. Only confirmed bedbound pts were designated PS4. Percentage chemotherapy doses delivered were calculated against the projected full dose and categorised into ≥85% Full, 60–85% RD, 30–60% HD. Pts receiving CHOP±R or CODOX-M/IVAC were called intensive (Int) and pts receiving low dose regimens called non-intensive (NI). Results 61 pts were found and 37 were inpatients. Of the 37 inpatients, 30 received chemotherapy, 29 for DLBCL and 1 for BL. Of the 30 treated pts (table 1) where parameters were assessable, LDH raised 92%, R-IPI ≥3 97%, PS 3/4 in 93%, stage3/4 86%, albumin <35g/l 70%. Of the 30 patients treated with chemotherapy, 18 achieved a CR with a median OS of 39 months(m) (range 8–123). There were 23 Int pts (9 were PS4, 7 of these being moribund), and 16 achieved CR median OS 48 m (range 12–99), 6 of them being PS4 and 4 were moribund. All pts achieving CR remained so except 1 late relapse (96m). Comorbidities were supported but did not influence treatment decisions except poor ejection fraction or dementia. (7 patients received no chemotherapy; declined ×3, cancer ×1, dementia ×1, not referred ×2) Discussion Our data show that very poor PS elderly pts can achieve CR (70%) with good OS with current intensive chemotherapy (CHOP±R, CODOX-M/IVAC±R). Further discussion refers to these pts (Int). CRs not only occurred in the PS2/3 pts, but also in 6/9 PS4 pts. The survivors could not be predicted and included 4 moribund pts. Toxicities were acceptable. Three of 4 moribund pts who survived received HD chemotherapy which was staggered due to emergency presentation. The 2nd cycle was given as soon as possible if improvement occurred (all responders did) with escalation of chemotherapy doses. This aggressive chemotherapeutic approach may have contributed to the good response rate. Our data show that putative toxicity is not a barrier to treatment with judicious dose reduction in the 1st cycle. Retrospective PS attribution was a weakness of the study. But objective parameters eg LDH, IPI, albumin and chemotherapy dose delivered concurred with the scores supporting their validity. PS4 criteria were objective. These data are important because they represent pts mostly excluded from trials. Recent data suggest that comorbidities may not influence survival. Our data support this. We suggest that elderly very poor PS pts can tolerate curative chemotherapy with encouraging remission rates and OS. Previous poor results may be due partly to undertreatment and most pts should be offered proper curative chemotherapy. A positive medical team attitude may be important. Disclosures: No relevant conflicts of interest to declare.

Rituximab Plus Bendamustin (R-B) Treatment In Patients with Aggressive Large B-Cell Lymphoma (LBCL): Response and Tolerability - a Single Institution Experience

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 4900-4900
Author(s):  
Julia Horn ◽  
Martina Kleber ◽  
Ulrike Kohlweyer ◽  
Stefanie Hieke ◽  
Regina Herzog ◽  
...  
Keyword(s):  
Conflicts Of Interest ◽  
Performance Status ◽  
Progression Free Survival ◽  
Poor Performance ◽  
B Cell Lymphoma ◽  
Poor Performance Status ◽  
First Line ◽  
Documentation System ◽  
Cd34 Cells ◽  
Grade Iii

Abstract Abstract 4900 Introduction: Clinical studies have shown that Rituximab plus Bendamustin (R-B) in indolent lymphoma results in favourable responses, progression free survival (PFS) and lower toxicity as compared to R-CHOP. The aim of this analysis was to characterize response and tolerability of R-B in patients with LBCL, who were not qualifying for R-CHOP due to age, comorbidity and/or prior pretreatment (including anthracyclines). Methods: We retrospectively identified consecutive patients with LBCL receiving at least two cycles of R-B in our department between 2003 and 2010 using our electronic tumor documentation system. Patient characteristics, response to R-B, and toxicity were assessed. Results: We identified 9 caucasian patients (5 females, 4 males) with LBCL; their median age was 71 years (range; 51–82). Two presented with stage I/II, seven with stage III/IV disease at initial diagnosis and before R-B. Six patients had a low or intermediate IPI and three were high risk. Four patients received R-B as first-line therapy, and five were treated for relapsed or refractory disease. Main determinants for the R-B-selection were contraindications for anthracyclines in five patients and advanced age and/or poor performance status in four patients. A median of four R-B-cycles were applied (range; 2–6). Response with achievement of CR and PR was observed in 6/9 (CR: 2, PR: 4), two achieved SD. Only one pt showed PD after four R-B cycles. The response of R-B in first-line vs. relapsed appeared similar. Of note, one female patient with secondary LCBL, after initial Hodgkin's lymphoma and C-MOPP chemotherapy (CTx) and mediastinal irradiation - with excellent response to R-B- failed to successfully mobilize PBSC thereafter. However, she was effectively mobilized with R-Ara-C-thiotepa (peripheral blood CD34+ cells were 5.82 vs. 54/μl, obtaining no vs. 6.72 × 106 CD34+ cells/kg KG via leukapheresis, respectively). Clinical tolerance of R-B in all patients was excellent in a total of 31 R-B-cycles, only two major CTC-events occurred: one infection (CTC grade III) and one thromboembolism (grade IV). Median PFS and overall Survival (OS) were 16 (7- not reached) and 20 (11-21) months. Conclusions: If standard R-CHOP cannot be given due to age, comorbidity or CTx-contraindications (e.g. anthracyclines), R-B may represent an effective treatment in LBCL. Larger cohorts and prospective clinical trials are needed to confirm these promising results. Currently, patients with grade III/IV follicular lymphoma are additionally evaluated for response and tolerability under R-B, also being presented at the meeting. Disclosures: No relevant conflicts of interest to declare.

Prognostic Significance of Elevated Serum Ferritin Before Chemotherapy in Patients with Non-Hodgkin's Lymphoma

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 5099-5099
Author(s):  
Kyung Ah Yoh ◽  
Ho Sup Lee ◽  
Lee Chun Park ◽  
Eun Mi Lee ◽  
Dae Jin Park ◽  
...  
Keyword(s):  
Serum Ferritin ◽  
Normal Limit ◽  
Cell Lymphoma ◽  
Ferritin Level ◽  
Performance Status ◽  
B Cell Lymphoma ◽  
High Serum ◽  
Stage Iii ◽  
Poor Performance Status ◽  
High Level

Abstract Abstract 5099 Background: Elevated ferritin level before stem cell transplantation was documented an adverse prognostic factor for patients undergoing hematopoietic stem cell transplantation for hematologic malignancies. Until now, there have been reported few studies which suggested high serum ferritin level were associated with worse outcomes for lymphoma. The purpose of this study was to find the significance of high levels of serum ferritin for predicting survival outcome in patients with non-Hodgkin's lymphoma (NHL). Methods: A total of 267 patients who newly diagnosed and received an chemotherapy at the Kosin University Gospel Hospital, Busan, South Korea between September 1999 and April 2012 were enrolled retrospectively in the current study. Pretreatment serum ferritin was measured within 2 weeks before the beginning of first line chemotherapy. The enrolled diseases included diffuse large B cell lymphoma (DLBL, n=163, 61. 0%), T cell lymphoma (TCL, n=48, 18. 0%) and other lymphoma (n=56, 21. 0%) including mantle cell lymphoma, marzinal zone B cell lymphoma, follicular lymphoma, small lymphocytic lymphoma and burkitt's lymphoma. In this study, patients with Hodgkin's disease and with undergoing chemotherapy 3 cycles or less than 3 cycles were excluded. Results: The median age of patients was 56 years (range, 14–84 years) and the mean level of serum ferritin at pre-treatment was 257. 79 ng/ml (range: 1. 70–6562. 00). In univariate anaylsis, factors associated with prolonged progression free survival (PFS) were LDH (p < 0. 001, 65. 8% in less than normal limit vs 39. 3% in more than normal limit), stage (p=0. 003, 64. 3% in less than stage III vs 46. 1% in stage III or more than), CRP (p = 0. 001, 58. 8% in less than 5mg/dL vs 27. 0% in 5mg/dL or more than), beta2-microglobulin (p < 0. 001, 59. 2% in less than 3. 5mg/L vs 29. 4% in 3. 5 mg/L or more than), and serum ferritin (p < 0. 001, 59. 2% in less than 500 ng/ml vs 22. 1% in 500 ng/ml or more than). Factors associated with prolonged overall survival (OS) were age (p < 0. 001, 61. 5% in less than 60 years vs 38. 4% in 60 years or more than), LDH (p < 0. 001, 70. 9% in less than normal limit vs 30. 0% in more than normal limit), ECOG performance status (p < 0. 001, 72. 8% in less than 2 scores vs 41. 9% in 2 scores or more than), stage(p=0. 005, 63. 4% in less than stage III vs 42. 1% in stage III or more than), Bulky mass (p = 0. 001, 57. 4% in tumor diameter less than 10cm vs 33. 5% in 10cm or more than), CRP (p = 0. 001, 60. 4% in less than 5mg/dL vs 27. 0% in 5mg/dL or more than), beta2-microglobulin (p < 0. 001, 59. 3% in less than 3. 5 mg/L vs 16. 3% in 3. 5 mg/L or more than), absolute lymphocyte count (p < 0. 001, 32. 2% in less than 1. 0 × 103/uL vs 59. 2% in 1. 0 × 103/uL or more than) and serum ferritin (p < 0. 001, 56. 9% in less than 500 ng/ml vs 23. 6% in 500 ng/ml or more than). In multivariate analysis, high level of LDH (RR (relative risk) = 0. 561, 95%CI: 0. 035–0. 890, P=0. 014), high level of beta2-microglobulin (RR= 0. 491, 95%CI: 0. 274–0. 880, P=0. 017) and high levels of serum ferritin (RR= 0. 557, 95%CI: 0. 311–0. 997, P=0. 049) were significant independent prognostic factors for PFS and high level of LDH (RR= 0. 418, 95%CI: 0. 269–0. 650, P < 0. 001), poor performance status (RR= 0. 467, 95%CI: 0. 295–0. 741, P=0. 001), high level of beta2-microglobulin (RR= 0. 461, 95%CI: 0. 278–0. 764, P=0. 003), and high levels of serum ferritin (RR= 0. 562, 95%CI: 0. 329–0. 958, P=0. 034) were significant independent prognostic factors for OS. Conclusions: High serum ferritin level of 500 ng/ml or more than 500 ng/ml may prognostic factor for survival outcomes including high LDH level, poor performance status, and high level of beta2-microglobulin in NHL. However, further studies are needed to confirm prognostic value of serum ferritn. Disclosures: No relevant conflicts of interest to declare.

High Serum Lactate Dehydrogenase (LDH) Is An Important Prognostic Factor in the Era of Novel Agents and Adds to the Prognostic Value of the International Staging System (ISS) in Patients with Multiple Myeloma.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 1819-1819
Author(s):  
Dimopoulos A. Dimopoulos ◽  
Maria Roussou ◽  
Anastasia Pouli ◽  
Eirini Katodritou ◽  
Argiris Symeonidis ◽  
...  
Keyword(s):  
Median Survival ◽  
Prognostic Value ◽  
Performance Status ◽  
Univariate Analysis ◽  
Prognostic Significance ◽  
Elevated Serum ◽  
High Serum ◽  
Serum Lactate Dehydrogenase ◽  
Agent Based ◽  
Novel Agent

Abstract Abstract 1819 Poster Board I-845 Several older studies have shown that high serum LDH is associated with features of advanced disease and with an inferior survival of symptomatic patients with MM who require treatment. It is however unclear whether LDH may add to the prognostic value of ISS and whether it may retain its prognostic significance in patients who have been exposed to novel agent-based therapies either at diagnosis or later in the course of their disease. In order to address these issues we analyzed 996 consecutive symptomatic patients who were included in the data base of the Greek Myeloma Study Group and who received frontline treatment between January 1995 and December 2008. Elevated serum LDH to ≥300 IU/L (normal levels <225 IU/L) was observed in 11% of patients. High LDH was seen more often in patients with impaired performance status (p<0.01), with anemia (p<0.01), with thrombocytopenia (p<0.01), with renal impairment (p<0.01), with high ISS (p<0.01), and with hypercalcemia (p=0.01). The median survival of all patients was 40 months with a clear improvement for patients who started treatment after January 2000 as compared to patients who started treatment before that date (50 months versus 31 months; p<0.01). Multiple clilnical and laboratory variables correlated with the probability of survival in univariate analysis. A multivariate analysis showed that the following variables had an independent prognostic significance: LDH (p<0.001), ISS (p<0.001), performance status (p<0.001), age (p<0.001) and platelet count (p<0.001). The median survival of patients with high versus normal LDH was 15 months versus 44 months (p<0.001). High LDH was observed in 7% of patients with ISS-1, in 10% of ISS-2 and 12% of ISS-3. Within each ISS subgroup the presence of high LDH was associated with a worse median survival. In ISS-1 the median survival of patients with high LDH was 22 months (CI 95%: 10-35) while the median survival of those with normal LDH was 76 months (CI 95%: 61-91; p<0.01). Similarly in ISS-2 the median survival of patients with high and normal LDH was 11 months (CI 95%: 7-14) and 40 months (CI 95%: 32-48), respectively (p<0.001), while in ISS-3 it was 17 months (CI 95%: 11-23) and 27 months (CI 95%: 21-33), respectively (p<0.01). Subsequently, patients were separated into two groups: patients who started treatment between January 1995 and December 1999 and patients who started therapy after January 2000 i.e. patients who had access to novel agent-based therapy. In both groups the presence of high LDH was related with statistically worse survival. In patients who received treatment before January 2000, the median survival in the high LDH group was 10 months (CI 95%: 4-16) versus 36 months in the normal LDH group (CI 95%: 31-42; p<0.001). Similarly, in patients who received treatment after January 2000, the median survival in the high LDH group was 21 months (CI 95%: 12-29) versus 51 months in the normal LDH group (CI 95%: 40-63; p<0.001). We conclude that serum LDH is a readily available and inexpensive variable which has a major impact on the survival of patients with myeloma even when they belong to a low or intermediate ISS subgroup and even when they receive novel agent-based therapy. Disclosures No relevant conflicts of interest to declare.

The utility of serum lactate dehydrogenase (LDH) in the follow-up of patients with diffuse large B-cell lymphoma (DLBCL).

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 8047-8047
Author(s):  
Navneeth Rao Bongu ◽  
Basem M. William ◽  
Martin Bast ◽  
Gregory Bociek ◽  
Philip Jay Bierman ◽  
...  
Keyword(s):  
Prognostic Significance ◽  
B Cell Lymphoma ◽  
Fold Increase ◽  
Complete Response ◽  
Serum Lactate ◽  
High Serum ◽  
Serum Lactate Dehydrogenase ◽  
Predictive Values ◽  
The Mean

8047 Background: The prognostic significance of high serum LDH is well established for both indolent and aggressive lymphomas at diagnosis. The performance characteristics of LDH in predicting relapse after treatment in patients (pts) with DLBCL has not been well studied. The determination of utility of LDH monitoring in pts with DLBCL would have widespread practice implications. Methods: We searched the Nebraska Lymphoma Study Group database to identify pts with DLBCL who were treated with a rituximab-based regimen, from 2000 to 2010, and sustained a complete response (CR). For the pts who relapsed (RP), after sustaining a CR, we collected the LDH level at relapse and the LDH level 3 months prior (considered baseline). For pts who never relapsed (NR), we collected the last 2 LDH levels at follow-up; levels had to be at least 3 months apart. The relative increase of LDH was compared, to baseline, among RP vs. NR. Results: We identified 129 pts, 15 pts were excluded from the analysis as their LDH results were not available, 27 relapsed and 87 didn’t. Median age of pts was 57 years. Only 9/27 RP (33%) had increase in LDH above upper limit of normal (ULN) at relapse. The mean increase in LDH at relapse was 1.2 fold above the ULN for RP vs. 0.83 for NR (p=0.59). The mean increase in LDH, from baseline, was 1.1 fold in NR vs. 1.3 in RP (p=0.3). The likelihood ratio (LR) of relapse was 4.65 for pts who had 1.5 fold increase in LDH above baseline (1.5xLDH) vs. those who didn’t (p=0.03). The sensitivity, specificity, positive and negative predictive values of 1.5xLDH for detecting relapse, compared to clinical and imaging findings were 0.18, 0.95, 0.55, and 0.79 respectively. Also, 1.5xLDH at relapse was significantly associated with the presence of fever (LR=5.74; p=0.03) but not with other symptoms including drenching night sweats, anemia, or new/progressive lymphadenopathy. Conclusions: A 1.5 fold increase in LDH, over a period of 3 months, is associated with increased likelihood of relapse from DLBCL. Modest elevations in LDH (<1.5 fold of baseline) doesn’t seem to be associated with relapse. LDH, when elevated at least 1.5 fold of baseline, is a specific (i.e. 56%), but not a sensitive (i.e. 19%) marker, for relapse of DLBCL.

scholarly journals Clinical and prognostic significance of aberrant T-cell marker expression in 225 cases of de novo diffuse large B-cell lymphoma and 276 cases of other B-cell lymphomas

Oncotarget ◽  
2017 ◽  
Vol 8 (20) ◽  
pp. 33487-33500 ◽  
Author(s):  
Naoko Tsuyama ◽  
Daisuke Ennishi ◽  
Masahiro Yokoyama ◽  
Satoko Baba ◽  
Reimi Asaka ◽  
...  
Keyword(s):  
T Cell ◽  
B Cell ◽  
De Novo ◽  
Cell Lymphoma ◽  
Prognostic Significance ◽  
B Cell Lymphoma ◽  
Cell Marker ◽  
Large B Cell Lymphoma ◽  
Marker Expression ◽  
Large B Cell

scholarly journals Poor Prognosis of Diffuse Large B-Cell Lymphoma with Hepatitis C Infection

2021 ◽  
Vol 11 (9) ◽  
pp. 844
Author(s):  
Yu-Fen Tsai ◽  
Yi-Chang Liu ◽  
Ching-I Yang ◽  
Tzer-Ming Chuang ◽  
Ya-Lun Ke ◽  
...  
Keyword(s):  
Hepatitis C ◽  
B Cell ◽  
Cell Lymphoma ◽  
Performance Status ◽  
Poor Performance ◽  
B Cell Lymphoma ◽  
Liver Involvement ◽  
Poor Performance Status ◽  
Large B Cell Lymphoma ◽  
Large B Cell

Background: Hepatitis C virus (HCV) in diffuse large B-cell lymphoma (DLBCL) is associated with a higher prevalence and distinctive clinical characteristics and outcomes. Methods: A retrospective analysis of adult DLBCL patients from 2011 to 2015 was studied. Results: A total of 206 adult DLBCL were enrolled with 22 (10.7%) HCV-positive patients. Compared to HCV-negative patients, the HCV-positive group had a poor performance status (p = 0.011), lower platelet count (p = 0.029), and higher spleen and liver involvement incidences (liver involvement, p = 0.027, spleen involvement, p = 0.026), and they received fewer cycles of chemotherapy significantly due to morbidity and mortality (p = 0.048). Overall survival was shorter in HCV-positive DLBCL (25.3 months in HCV-positive vs. not reached (NR), p = 0.049). With multivariate analysis, poor performance status (p < 0.001), advanced stage (p < 0.001), less chemotherapy cycles (p < 0.001), and the presence of liver toxicity (p = 0.001) contributed to poor OS in DLBCL. Among HCV-positive DLBCL, the severity of liver fibrosis was the main risk factor related to death. Conclusion: Inferior survival of HCV-positive DLBCL was observed and associated with poor performance status, higher numbers of complications, and intolerance of treatment, leading to fewer therapy. Therefore, anti-HCV therapy, such as direct-acting antiviral agents, might benefit these patients in the future.

Primary T-Cell–Rich B-Cell Lymphoma Masquerading as a Meningioma

2000 ◽  
Vol 124 (11) ◽  
pp. 1700-1703
Author(s):  
Barbara H. Amaker ◽  
Nitya R. Ghatak ◽  
Sean A. Jebraili ◽  
Andrea Ferreira-Gonzalez ◽  
Michael J. Kornstein
Keyword(s):  
T Cell ◽  
B Cell ◽  
Cell Lymphoma ◽  
Prognostic Significance ◽  
B Cell Lymphoma ◽  
Large Cell ◽  
Molecular Techniques ◽  
First Case ◽  
Dural Lymphoma ◽  
Immunohistochemical Techniques

Abstract Primary dural lymphoma is rare, and few of the small number of cases reported to date have been classified using immunohistochemical techniques. To our knowledge, we report the first case of T-cell–rich B-cell lymphoma (diffuse mixed small cell and large cell) presenting as a solitary intracranial dural mass. Cytologic and frozen sections prepared during intraoperative consultation revealed a polymorphic population of lymphocytes suspicious for an inflammatory process. Permanent sections of the dura showed a diffusely infiltrating mass composed of mature lymphocytes peppered with large atypical lymphocytes. Immunohistochemical stains identified the small lymphocytes as T cells (CD3 and CD43) and the large atypical lymphocytes as B cells (CD20). Evidence of rearranged immunoglobulin heavy-chain genes demonstrated B-cell monoclonality. Differentiating between inflammatory and neoplastic lymphocytic masses of the dura obviously has important therapeutic and prognostic significance and may require immunohistochemical and molecular techniques.

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