Impact of Rituximab and Radiotherapy on Outcome of Patients With Aggressive B-Cell Lymphoma and Skeletal Involvement

Held, Gerhard; Zeynalova, Samira; Murawski, Niels; Ziepert, Marita; Kempf, Barbara; Viardot, Andreas; Dreyling, Martin; Hallek, Michael; Witzens-Harig, Mathias; Fleckenstein, Jochen; Rübe, Christian; Zwick, Carsten; Glaß, Bertram; Schmitz, Norbert; Pfreundschuh, Michael

doi:10.1200/jco.2012.48.0467

Cited by 95 publications

(83 citation statements)

References 33 publications

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“…This is not only due to the smaller number of patients treated with rituximab; rather, that rituximab quenches differences between prognostic subgroups by improving the outcome of poor-prognosis subgroups more than that of patients with low IPI appears to be responsible for this observation (Table 2). 27 Our results do not support the generalizing conclusion of a Spanish study, that rituximab works better in lymphatic than extralymphatic disease 28 ; rather, the results of this study and our recently published study of skeletal involvement 29 suggest that differences in rituximab efficacy between lymphatic and extralymphatic sites may exist for some (eg, skeletal involvement), but not for other (eg, craniofacial) extralymphatic sites of involvement.…”

Section: Discussioncontrasting

confidence: 56%

The role of radiotherapy and intrathecal CNS prophylaxis in extralymphatic craniofacial aggressive B-cell lymphomas

Murawski

Held

Ziepert

et al. 2014

Blood

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Key Points• The results of this retrospective analysis do not support intrathecal prophylaxis or radiotherapy to E CFI patients in complete remission/unconfirmed complete remission.To define the role of radiotherapy and intrathecal prophylaxis in extralymphatic craniofacial involvement (E CFI ) of aggressive B-cell lymphoma, we analyzed 11 consecutive German High-Grade Non-Hodgkin Lymphoma Study Group trials. E CFI occurred in 290/4155 (7.0%) patients (orbita, 31; paranasal sinuses, 93; main nasal cavity, 38; tongue, 27; remaining oral cavity, 99; salivary glands, 54). In a multivariable analysis adjusted for International Prognostic Index rituximab improved event-free and overall survival both in patients with and without E CFI . Three-year event-free (79% vs 79%; P 5 .842) and overall survival (86% vs 88%; P 5 .351) rates were similar in 145 patients receiving and 57 not receiving radiotherapy. Without rituximab, the 2-year cumulative rate of central nervous system (CNS) disease was increased in 205 E CFI patients compared with 2586 non-E CFI patients (4.2% vs 2.8%; P 5 .038), whereas this was not observed with rituximab (1.6% in 83 E CFI vs 3.4% in 1252 non-E CFI patients; P 5 .682). In 88 E CFI patients who received intrathecal prophylaxis with methotrexate, the 2-year rate of CNS disease was 4.2% compared with 2.3% in 191 patients who did not (P 5 .981). In conclusion, rituximab eliminates the increased risk for CNS disease in patients with E CFI . This retrospective analysis does not support intrathecal prophylaxis or radiotherapy to E CFI patients in complete remission/unconfirmed complete remission. These findings should be confirmed in a prospective study. (Blood. 2014;124(5):720-728)

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Section: Discussioncontrasting

confidence: 56%

The role of radiotherapy and intrathecal CNS prophylaxis in extralymphatic craniofacial aggressive B-cell lymphomas

Murawski

Held

Ziepert

et al. 2014

Blood

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“…[14] In a large study on DLBCL with skeletal involvement (which included 52 cases of PB-DLBCL), Held and coworkers also demonstrated a positive impact of radiotherapy on survival. [31] The question of RT as a therapeutic modality in PB-DLBCL -in combination with immunochemotherapy -may represents a pivotal question for future prospective clinical trials.…”

Section: Discussionmentioning

confidence: 99%

Primary bone diffuse large B-cell lymphoma: a retrospective evaluation on 76 cases from French institutional and LYSA studies

Pilorge

Harel

Ribrag

et al. 2016

Leukemia & Lymphoma

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Primary bone diffuse large B-cell lymphoma (PB-DLBCL) is a rare DLBCL location variant. We treated 76 PB-DLBCL patients by immuno-chemotherapy, resulting in an 84% sustained complete remission rate and a 78.9% survival over a 4.7-year median follow-up period. Ann Arbor stage IV and high age-adjusted international prognostic index were predictive of adverse outcome in univariate analysis. In multivariate analysis using a Cox model, only aa-IPI predicted long-term survival. While based on a limited number of cases, we suggested that radiotherapy may be useful as a consolidation modality in PB-DLBCL. We also suggested that positron emission tomography/ CT scan should be interpreted with caution due to a persistent [18F]fluorodeoxyglucose [18FDG] uptake of bone lesions even after remission in some in PB-DLBCL patients. Our study based on a homogeneous cohort of PB-DLBCL patients confirmed the favorable outcome of this DLBCL variant and support the implementation of prospective clinical trials in this disease. ARTICLE HISTORY

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“…The staging procedures will include thoracic-abdominal-pelvic computed tomography (CT) scan, bone-marrow biopsy and cerebrospinal fluid cytology. The disease stage is determined using the Ann Arbor criteria of which divided into four stages (I-IV) and the majority having extra-nodal stage I or II (IE or IIE) disease [10]. Bulky disease is defined as a lesion exceeding >5 cm [11,12].…”

Section: Investigationsmentioning

confidence: 99%

Primary Lymphoma of Bone Literature Review

Elhassadi¹

2017

J Orthop Oncol

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Primary Lymphoma of Bone (PLB) is a very rare neoplasm presenting most commonly with bone pain and swelling or as an incidental finding on imaging. PLB diagnosis requires tissue biopsy and Non-Hodgkin's lymphoma (NHL) is the commonest sub-type. Disease staging includes thoracic-abdominal-pelvic computed tomography scan (CT), bone marrow biopsy and cerebrospinal fluid cytology. Chemo-immunotherapy with radiotherapy (RT) consolidation is a widely applied treatment strategy for PLB with good outcomes achieved.

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Impact of Rituximab and Radiotherapy on Outcome of Patients With Aggressive B-Cell Lymphoma and Skeletal Involvement

Cited by 95 publications

References 33 publications

The role of radiotherapy and intrathecal CNS prophylaxis in extralymphatic craniofacial aggressive B-cell lymphomas

The role of radiotherapy and intrathecal CNS prophylaxis in extralymphatic craniofacial aggressive B-cell lymphomas

Primary bone diffuse large B-cell lymphoma: a retrospective evaluation on 76 cases from French institutional and LYSA studies

Primary Lymphoma of Bone Literature Review

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