Diffuse Large-Cell Lymphoma of the Testis

1999 ◽  
Vol 17 (9) ◽  
pp. 2854-2854 ◽  
Author(s):  
Carlo Tondini ◽  
Andrés J.M. Ferreri ◽  
Licia Siracusano ◽  
Pinuccia Valagussa ◽  
Roberto Giardini ◽  
...  
Keyword(s):  
Cell Lymphoma ◽  
Systemic Disease ◽  
International Prognostic Index ◽  
Large Cell ◽  
High Dose ◽  
Diffuse Large Cell Lymphoma ◽  
Contralateral Testis ◽  
Limited Stage ◽  
Ann Arbor ◽  
Large Cell Lymphoma

PURPOSE: To evaluate clinical outcome of patients with testicular diffuse large-cell lymphoma treated with conventional-dose systemic chemotherapy. PATIENTS AND METHODS: This study is a retrospective analysis of adult patients with testicular diffuse large-cell lymphoma who were treated with a doxorubicin-based chemotherapy regimen at our institution, the Istituto Nazionale Tumori of Milan. Twenty-nine assessable patients, with a median age of 61 years, were identified. Sixteen patients had limited stage (Ann Arbor stage I/II) disease, whereas 13 patients had a testicular mass and distant organ involvement (Ann Arbor stage IV). Patients were retrospectively classified according to the International Prognostic Index. RESULTS: After a median follow-up of 82 months, 22 patients presented disease progression and 22 patients had died. Actuarial median time to treatment failure and overall survival were 44 and 41 months for patients with limited stage and 9 and 16 months for patients with advanced stage, respectively. Eight patients failed initial treatment, and 14 patients relapsed from clinical remission after a median disease-free time of 17 months (range, 6 to 98 months). Median survival time after progression of lymphoma was 5 months (range, 0 to 22 months). In nine (41%) of the 22 failing patients, the initial site of relapse was either the CNS or the contralateral testis; the remaining patients experienced relapse in multiple extranodal sites. CONCLUSION: Poor prognosis of patients with diffuse large-cell lymphoma calls for more effective treatment strategies, such as high-dose chemotherapy programs for younger patients or specifically designed chemotherapy regimens for patients not suitable for high-dose treatment, with the purpose to provide control of both systemic disease and disease of the CNS and contralateral testis. The potential benefit of contralateral testicular irradiation has to be taken into account in the treatment planning.

Brief Chemotherapy and Involved-Region Irradiation for Limited-Stage Diffuse Large-Cell Lymphoma: An 18-Year Experience From the British Columbia Cancer Agency

2002 ◽  
Vol 20 (1) ◽  
pp. 197-204 ◽  
Author(s):  
Tamara N. Shenkier ◽  
Nicholas Voss ◽  
Randall Fairey ◽  
Randy D. Gascoyne ◽  
Paul Hoskins ◽  
...  
Keyword(s):  
Cell Lymphoma ◽  
International Prognostic Index ◽  
Prognostic Index ◽  
Large Cell ◽  
Diffuse Large Cell Lymphoma ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Limited Stage ◽  
Two Factors ◽  
Large Cell Lymphoma

PURPOSE: To evaluate clinical outcome of patients with limited-stage diffuse large-cell lymphoma (DLCL) treated with three cycles of chemotherapy followed by involved-region irradiation (IRRT). PATIENTS AND METHODS: Adults with limited-stage DLCL were treated with brief doxorubicin-containing chemotherapy regimens between 1980 and 1998. IRRT was administered 3 to 4 weeks after the third chemotherapy treatment in a dose equivalent to 30 Gy in 10 fractions. RESULTS: Three hundred and eight patients (median age, 64 years) were included, and 299 experienced complete remission. After a median follow-up of 86 months, 64 patients developed progressive disease, and 104 patients died (43 from lymphoma, three from toxicity, and 58 from other causes). Actuarial overall and progression-free survival (PFS) rates were, respectively, 80% and 81% at 5 years and 63% and 74% at 10 years. For subgroups identified using the Miller modification of the International Prognostic Index (IPI), the overall survival rates at 5 and 10 years were, respectively, 97% and 89% (no factors), 77% and 56% (one or two factors), and 58% and 48% (three or four factors), and the 5-year and 10-year PFS rates were, respectively, 94% and 89% (no factors), 79% and 73% (one or two factors), and 60% and 50% (three or four factors). Men with testicular presentation, had a definitely inferior outcome. CONCLUSION: Long-term outcome with three cycles of doxorubicin-based chemotherapy and IRRT confirms that this is a successful approach for the majority of patients with limited-stage DLCL. Subgroups with worse prognoses can be identified, and these patients should be offered alternative treatment approaches.

High-dose chemotherapy for relapsed and refractory diffuse large B-cell lymphoma: mediastinal localization predicts for a favorable outcome.

1998 ◽  
Vol 16 (1) ◽  
pp. 63-69 ◽  
Author(s):  
U Popat ◽  
D Przepiork ◽  
R Champlin ◽  
W Pugh ◽  
K Amin ◽  
...  
Keyword(s):  
B Cell ◽  
Cell Lymphoma ◽  
Disease Free Survival ◽  
Large Cell ◽  
High Dose Chemotherapy ◽  
High Dose ◽  
Free Survival ◽  
Ann Arbor ◽  
Large Cell Lymphoma ◽  
Disease Free

PURPOSE This study was performed to evaluate the outcome of high-dose chemotherapy and autologous transplantation in patients with diffuse B-cell large-cell lymphoma, and, specifically, to evaluate the impact of primary mediastinal localization on the outcome of high-dose chemotherapy. PATIENTS AND METHODS A retrospective review was performed of all patients with diffuse large B-cell lymphoma who underwent autologous marrow or peripheral-blood stem-cell transplantation at our institution between January 1 986 and December 1995. RESULTS Ninety patients were identified, of whom 31 (34%) had a primary mediastinal B-cell large-cell lymphoma (PML). Cumulative probabilities of disease-free survival, overall survival, and disease progression are 40% (95% confidence interval [CI], 29 to 51), 42% (95% CI, 31 to 53), and 52% (95% CI, 40 to 64), respectively. By univariate analysis, low lactate dehydrogenase (LDH) level and low Ann Arbor stage at transplant were associated with improved survival and disease-free survival. There was a trend for improved disease-free survival and survival for patients with PML. Multivariate stepwise Cox regression analysis showed that LDH level, Ann Arbor stage, and primary mediastinal localization were independent favorable prognostic factors for disease-free survival and survival. LDH level and Ann Arbor stage were also predictive for the risk of disease progression. CONCLUSION Our results indicate that patients with PML may display an increased susceptibility to high-dose chemotherapy compared with other types of B-cell large-cell lymphoma. These findings, if confirmed, may have implications for the initial management of patients with PML.

Delphi-Panel Analysis of Appropriateness of High-Dose Chemotherapy and Blood Cell or Bone Marrow Autotransplants in Diffuse Large-Cell Lymphoma

1998 ◽  
Vol 32 (1-2) ◽  
pp. 139-149 ◽  
Author(s):  
Robert Peter Gale ◽  
Rolla Edward Park ◽  
Robert Dubois ◽  
Philip Jay Bierman ◽  
Richard I. Fisher ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Blood Cell ◽  
Cell Lymphoma ◽  
Large Cell ◽  
High Dose Chemotherapy ◽  
Delphi Panel ◽  
High Dose ◽  
Panel Analysis ◽  
Diffuse Large Cell Lymphoma ◽  
Large Cell Lymphoma

Predictive value for survival of a risk model of two serological markers, beta-2-microglobulin (B2M) and lactic dehydrogenase (LDH), in diffuse large cell lymphoma (DLCL)

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 10599-10599
Author(s):  
M. A. Rodriguez ◽  
S. Temple ◽  
L. Fayad ◽  
F. Hagemeister ◽  
P. McLaughlin ◽  
...  
Keyword(s):  
Risk Model ◽  
Factor Model ◽  
Cell Lymphoma ◽  
International Prognostic Index ◽  
Significant Risk ◽  
Prognostic Index ◽  
Large Cell ◽  
Prognostic Indicator ◽  
Diffuse Large Cell Lymphoma ◽  
Large Cell Lymphoma

10599 Background: The International Prognostic Index (IPI), the standard tumor risk model in patients (pts) with diffuse large cell lymphoma (DLCL), has 5 factors (age, LDH, performance status, extra nodal sites, and stage). We previously proposed a simpler two-factor model, based on LDH and B2M (JCO10;1989). B2M is a component of HLA class I antigens, expressed in lymphocytes, and a known prognostic indicator in some lymphoid malignancies. The benefits of this model are: objective measures; lab method widely available; simplicity; biologic marker. Methods: We applied the model to a large cohort of DLCL patients with prospective baseline B2M, and treated with doxorubicin-based (chemo) regimens, with and without rituximab. 718 pts with DLCL were sequentially treated at MDACC by IRB approved chemo protocols from 1988–2000. In 2001, rituximab plus chemo (RCHOP) became standard. 311 DLCL pts were sequentially treated with RCHOP from 2001–2005. Cox regression analyses for univariate and multivariate models of IPI factors and B2M were done. Kaplan-Meier survival projections were in three risk categories: low (normal [nl] LDH and B2M); intermediate (either LDH or B2M > nl); or high (LDH and B2M > nl). Results: In both treatment groups, IPI factors and B2M were significant as univariate factors. In the RCHOP group, however, the IPI multivariate model showed age, stage, and extra-nodal sites were not significant risk factors, while B2M and LDH remained highly significant (p<0.01). The 5 year survival projections by risk category were: (*) combines intermediate low and intermediate-high categories Conclusions: This simple two-factor model predicts risk for patients with DLCL, treated with or without rituximab, comparably to the IPI. B2M should be considered an important prognostic indicator in DLCL, particularly in rituximab treated patients. Exploratory analyses to revise the IPI model are indicated. [Table: see text] No significant financial relationships to disclose.

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