Clinical characteristics and prognostic analysis of Chinese patients with diffuse large B-cell lymphoma

Ke, Xiaoyan; Wang, Jing; Gao, Zifen; Zhao, Lingzhi; Li, Min; Jing, Hongmei; Wang, Jijun; Zhao, Wei; Gilbert, Heather; Yang, Xiaofeng

doi:10.1016/j.bcmd.2009.09.002

Cited by 4 publications

(7 citation statements)

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“…Our previous study showed that the prevalence and clinical and laboratory characteristics of lymphomas among Han people in China may be different from that in other populations [11,12], suggesting that genetic background and environmental factors may affect the genesis, expression of biomarkers, and prognosis of lymphomas. So, it is necessary to analyze the clinical features associated with ALK + and ALK - in a Han Chinese patient population and their prognostic significance.…”

Section: Introductionmentioning

confidence: 99%

Clinical and laboratory characteristics of systemic anaplastic large cell lymphoma in Chinese patients

et al. 2012

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BackgroundSystemic anaplastic large cell lymphoma (S-ALCL) is a rare disease with a highly variable prognosis and no standard chemotherapy regimen. Anaplastic lymphoma kinase (ALK) has been reported as an important prognostic factor correlated with S-ALCL in many but not all studies. In our study, we retrospectively analyzed 92 patients with S-ALCL from the Peking University Lymphoma Center for clinical and molecular prognostic factors to make clear the role of ALK and other prognostic factors in Han Chinese S-ALCL.ResultsThe majority of Chinese S-ALCL patients were young male patients (median age 26, male/female ratio 1.7) and the median age was younger than previous reports regardless of ALK expression status. The only statistically significant different clinical characteristic in S-ALCL between ALK positive (ALK+) and ALK negative (ALK-) was age, with a younger median age of 22 for ALK+ compared with 30 for ALK-. However, when pediatric patients (≤18) were excluded, there was no age difference between ALK+ and ALK-. The groups did not differ in the proportion of males, those with clinical stage III/IV (49 vs 51%) or those with extranodal disease (53 vs 59%). Of 73 evaluable patients, the 3-year and 5-year survival rates were 60% and 47%, respectively. Univariate analysis showed that three factors: advanced stage III/IV, lack of expression of ALK, and high Ki-67 expression, were associated with treatment failure in patients with S-ALCL. However, ALK expression correlated with improved survival only in patients younger than 14 years, while not in adult patients. In multivariate analysis, only clinical stage was an independent prognostic factor for survival. Expressions of Wilms tumor 1 (WT1) and B-cell lymphoma 2 protein (BCL-2) correlated with the expression of ALK, but they did not have prognostic significance. High Ki-67 expression was also a poor prognostic factor.ConclusionsOur results show that ALK expression alone is not sufficient to determine the outcome of ALCL and other prognostic factors must be considered. Clinical stage is an independent prognostic factor. Ki-67 expression is a promising prognostic factor.

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Section: Introductionmentioning

confidence: 99%

Clinical and laboratory characteristics of systemic anaplastic large cell lymphoma in Chinese patients

et al. 2012

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“…Furthermore, 77.3% of CD20-negative DLBCL patients were defined as the non-GCB subtype according to Hans et al [17]. In comparison, the rate of non-GCB subtypes was only 34.4% and 58.4% in our control group and another Chinese study comprising conventional DLBCL [2], respectively. Interestingly, our study showed that 36% of CD20-negative DLBCL patients were CD30-positive.…”

Section: Discussionmentioning

confidence: 60%

“…Diffuse large B-cell lymphoma (DLBCL) is the most frequent subtype of non-Hodgkin’s lymphoma (NHL) in Western and Eastern countries, representing 30%-40% of all non-Hodgkin’s lymphoma cases [1,2]. CD20 antigen is a membrane-bound protein which plays a role in B-cell activation, differentiation, and cell-cycle progression [3-5].…”

Section: Introductionmentioning

confidence: 99%

CD20-negative de novo diffuse large B-cell lymphoma in HIV-negative patients: A matched case-control analysis in a single institution

Rao

et al. 2012

J Transl Med

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BackgroundHIV-negative, CD20-negative de novo diffuse large B-cell lymphoma (DLBCL) patients has rarely been reported. To elucidate the nature of this entity, we retrospectively reviewed the data of 1,456 consecutive de novo DLBCL patients who were treated at Sun Yat-Sen University Cancer Center between January 1999 and March 2011.MethodsThe pathologic characteristics of CD20-negative patients, clinical features, response to initial treatment, and outcomes of 28 patients with available clinical data (n = 21) were reviewed. Then, a matched case-control (1:3) analysis was performed to compare patients with CD20-negative and -positive DLBCL.ResultsThe median age of the 28 CD20-negative DLBCL patients was 48 years, with a male-female ratio of 20:8. Seventeen of 22 (77.3%) CD20-negative DLBCL cases were of the non-germinal centre B-cell (non-GCB) subtype. High Ki67 expression (≥80%), an index of cell proliferation, was demonstrated in 17 of 24 (70.8%) cases. Extranodal involvement (≥ 1 site) was observed in 76.2% of the patients. Following initial therapy, 9 of 21 (42.9%) cases achieved complete remission, 4 (19%) achieved partial remission, 1 (4.8%) had stable disease, and 7 (33.3%) had disease progression. The median overall survival was 23 months. The 3-year progression-free survival (PFS) and overall survival (OS) rates were 30.5% and 35%, respectively. A matched case-control analysis showed that patients with CD20-negative and -positive DLBCL did not exhibit a statistically significant difference with respect to the main clinical characteristics (except extranodal involvement), whereas the patients with CD20-positive DLBCL had a better survival outcome with 3-year PFS (P = 0.008) and OS (P = 0.008) rates of 52% and 74.1%, respectively.ConclusionsThis study suggests that HIV-negative, CD20-negative de novo DLBCL patients have a higher proportion of non-GCB subtype, a higher proliferation index, more frequent extranodal involvement, a poorer response, and a poorer prognosis to conventional treatment compared to patients with CD20-positive DLBCL. Further studies are warranted to investigate new target and optimal therapy of CD20-negative de novo DLBCL.

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“…La alta frecuencia de infiltración extranodal es menor con la de los pacientes asiáticos con LBDCG, en quienes hasta 86.5% presentan afección de uno o más órganos extrano- dales (25,27), pero es superior que la encontrada por otros investigadores (24,(28)(29)(30), como López y colaboradores, quienes describieron las características clinicopatológicas de 382 pacientes diagnosticados con LBDCG durante un período de 13 años y encontraron que 71% de los pacientes tenían infiltración extranodal y los sitios infiltrados con mayor frecuencia fueron la médula ósea (19%) y el tracto gastrointestinal (12%) ( 29), lo cual concuerda con lo encontrado en el estudio (22.9 y 10%, respectivamente). Dada la marcada heterogeneidad clínica, histopatológica, genética, molecular y de respuesta al tratamiento que presentan los pacientes con LBDCG (1), la predicción acertada de la supervivencia facilita que se defina el esquema de tratamiento inicial con base en expectativas de supervivencia reales y a su vez, favorece una estadificación adecuada de los pacientes que vayan a participar en ensayos clínicos (12).…”

Section: Figura 2 Diferencias En La Concentración De β2 Microglobulina En Cada Grupo De Riesgo Ipi (A Y B) O Ipi Revisado (C)unclassified

“…En relación con los demás factores pronósticos que componen el IPI, la baja proporción de pacientes con estado Ann Arbor I o II difiere de estudios grandes, como el realizado por Grupo de Estudio Internacional en Linfomas (ILSG), en el cual 51% de los pacientes acudían en estado I o II (2). Por su parte, Sehn y colaboradores, en el estudio para la definición del IPI revisado, incluyeron 365 pacientes mayores de 16 años con LBDCG y observaron que 59% tenían un estado Ann Arbor III o IV (12), proporción similar al de los pacientes del presente estudio (62.5%) y al encontrado en series de pacientes asiáticos con LBDCG (62%) (27). Ello indica que en la población de estudio se presentó una evolución rápida del linfoma, o bien, hubo un periodo prolongado de tiempo entre el inicio de los síntomas, el diagnóstico y la instauración del tratamiento.…”

Section: Figura 2 Diferencias En La Concentración De β2 Microglobulina En Cada Grupo De Riesgo Ipi (A Y B) O Ipi Revisado (C)unclassified

Caracterización de factores pronósticos de pacientes con Linfoma B difuso de células grandes en un Hospital Universitario, 2009 – 2012

Guevara

Jaramillo

Rendon

et al. 2014

AMC

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Objetivo: describir los factores pronósticos demográficos, clínicos, hematológicos, inmunohistoquímicos y bioquímicos al diagnóstico de pacientes con linfoma B difuso de células grandes y su asociacióncon la severidad según el Índice Pronóstico Internacional en un Hospital Universitario, 2009-2012. Métodos: se realizó un estudio descriptivo en 40 pacientes con dicho linfoma. Se comparó laconcentración de β2 microglobulina con los factores pronósticos que componen el IPI y otros que nohacen parte; se determinó la asociación entre el IPI e IPI revisado y la concentración de β2 microglobulina,infiltración medular, masa voluminosa y expresión de BCL-2 y Ki-67. La información se analizó en SPSS. Resultados: 40% de los pacientes pertenecían al grupo de riesgo alto según el IPI y 55% al grupocon pronóstico pobre según el IPI revisado; 82.5% expresaron BCL-2 y 61.5% tenían un Ki-67>70%.Se observó asociación entre la β2 microglobulina y el Ann Arbor (p=0.036), la β2 microglobulina y lainfiltración medular (p=0.003), y la β2 microglobulina y el IPI revisado (p=0.037). Conclusiones: es probable que el tiempo transcurrido entre la aparición de los síntomas y eldiagnóstico haya favorecido que los pacientes se presentaran en estados avanzados de la enfermedady como consecuencia, con un pronóstico pobre. Así mismo, el estudio de la infiltración medular, elporcentaje de expresión de Ki-67 y la concentración de β2 microglobulina favorece a la identificaciónde pacientes con un pronóstico adverso

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Clinical characteristics and prognostic analysis of Chinese patients with diffuse large B-cell lymphoma

Cited by 4 publications

References 26 publications

Clinical and laboratory characteristics of systemic anaplastic large cell lymphoma in Chinese patients

Clinical and laboratory characteristics of systemic anaplastic large cell lymphoma in Chinese patients

CD20-negative de novo diffuse large B-cell lymphoma in HIV-negative patients: A matched case-control analysis in a single institution

Caracterización de factores pronósticos de pacientes con Linfoma B difuso de células grandes en un Hospital Universitario, 2009 – 2012

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