Rituximab-Including Combined Modality Treatment for Primary Thyroid Lymphoma: An Effective Regimen for Elderly Patients

Watanabe, Natsuko; Narimatsu, Hiroto; Noh, Jaeduk Yoshimura; Kunii, Yo; Mukasa, Koji; Matsumoto, Masako; Suzuki, Miho; Sekiya, Keizo; Ohye, Hidemi; Yoshihara, Ai; Iwaku, Kenji; Kobayashi, Sachiko; Kameyama, Kaori; Kobayashi, Kazuhiko; Nishikawa, Yoshitaka; Kami, Masahiro; Sugino, Kiminori; Ito, Koichi

doi:10.1089/thy.2013.0523

Cited by 21 publications

(11 citation statements)

References 27 publications

(29 reference statements)

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“…Moreover, rituximab was approved by the U.S. Food and Drug Administration in 2006 as a first-line drug for PTL, and most of the DLBCL and mixed MALT and DLBCL patients who were expected to have poor prognosis were eligible for a combination rituximab and CHOP treatment regimen in this study. The combination of rituximab with CHOP is associated with improved survival rates among elderly patients with B-cell lymphoma and is a promising treatment for elderly patients with PTL [ 17 18 ]. Secondly, the proportion of patients with MALT lymphoma, which has better prognosis than DLBCL, was greater in the present study (42.1%) than in previous studies in the literature, which reported rates ranging from 10.0% to 28.0% [ 1 6 7 19 ].…”

Section: Discussionmentioning

confidence: 99%

Clinicopathological characteristics and treatment outcomes of 38 cases of primary thyroid lymphoma: a multicenter study

et al. 2015

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PurposePrimary thyroid lymphoma (PTL) is a rare disease and it has been investigated in a limited number of studies. The present multicenter study evaluated the clinical features and treatment outcomes of PTL.MethodsThe medical records of patients diagnosed with PTL between 2000 and 2013 in three centers were retrospectively reviewed.ResultsThe study included 11 men and 27 women with a median age of 63.3 years (range, 42-83 years). The median follow-up was 56.0 months (range, 3-156 months). Of the 38 patients included, 16 had mucosa-associated lymphoid tissue (MALT) lymphoma, six had mixed MALT and diffuse large B-cell lymphoma (DLBCL), and 16 had DLBCL. Thirty-five patients (92.1%) had early stage (stage I/II) disease. Of the 16 MALT lymphoma patients, 14 were treated by surgery, and radiotherapy (RT) or chemotherapy was combined in five patients. Two patients received RT or chemotherapy alone. Of the six mixed MALT and DLBCL patients, three underwent surgery with chemotherapy and three underwent chemotherapy alone, RT alone, or surgery with RT. All of the 16 DLBCL patients received chemotherapy, and surgery and RT was combined in 4 and 1 patients, respectively. The 5-year survival was 100% for MALT lymphoma (7 of 7) and mixed MALT and DLBCL patients (5 of 5) and 87.5% for DLBCL patients (7 of 8).ConclusionEarly stage PTL has an excellent prognosis when managed by single or combined treatment modalities. Clinicians should consider PTL in patients with underlying Hashimoto's thyroiditis presenting with an enlarging thyroid mass.

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Section: Discussionmentioning

confidence: 99%

Clinicopathological characteristics and treatment outcomes of 38 cases of primary thyroid lymphoma: a multicenter study

et al. 2015

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“…In case of aggressive histological subtype, such as DLBCL or a non‐localized indolent subtype, the PTL should be treated with both chemotherapy and RT …”

Section: Primary Thyroid Lymphoma: From Diagnosis To Treatmentmentioning

confidence: 99%

Lymphomas and thyroid: Bridging the gap

Mancuso

Carlisi

Napolitano

et al. 2018

Hematological Oncology

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The thyroid gland is often involved in the development of neoplastic diseases, including lymphoproliferative disorders. The aim of this paper is to provide a comprehensive overview of the multiple interactions between lymphoma and thyroid. Through an extensive research among the literature, the relationship between lymphomas and thyroid can be established at various levels, and the possible interconnections are here summarized in 5 points: (1) the greater risk of lymphoma development in some thyroid diseases; (2) the primary thyroid lymphoma, with focus on issues related to the diagnosis, differential diagnosis, and treatment; (3) the incidence of thyroid involvement in primitive nodal lymphomas or in extranodal lymphomas of the other sites; (4) thyroid changes after treatment of lymphoma, in relation to the effects of radiation therapy and immuno-chemotherapy; (5) the incidental findings of thyroid changes, on imaging, in patients with lymphoma, without a direct involvement of the gland in malignant disease. In conclusion, issues that until now have been dealt with separately will therefore be analyzed in a unique paper, allowing a global view of the topic and emphasizing the need of a multidisciplinary approach. Future learning areas in this topic mainly relate to rapidly increasing the knowledge of imaging studies together with expanding the armamentarium of novel biological and targeting agents in lymphoma patients.

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“…Dralle et al ( 15 ) suggested that rituximab could improve survival of patients with primary thyroid DLBCL. Watanabe et al ( 16 ) showed that the inclusion of rituximab to combination therapy was effective for elderly patients with primary thyroid DLBCL. These findings suggested that chemotherapy including rituximab in combination with supplementary radiotherapy may be optimal treatment modality for patients with primary thyroid DLBCL.…”

Section: Discussionmentioning

confidence: 99%

A Multicenter Retrospective Study of 58 Patients With Primary Thyroid Diffuse Large B Cell Lymphoma

Yi²,

Wang

et al. 2020

Front. Endocrinol.

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Background: Primary thyroid diffuse large B cell lymphoma (DLBCL) is a rare type of extranodal lymphoma; optimal treatment methods and the key prognostic factors have not been established. Methods: The clinical data of 58 patients with primary thyroid DLBCL from January 2007 to December 2017 were collected. The Kaplan–Meier method and log-rank tests were used for the survival analysis. Cox regression analysis was performed to evaluate the prognostic factors. Results: The follow-up time was 6–120 months; 5-year overall survival (OS) and progression-free survival (PFS) were 73 and 61%, respectively. Single-factor analysis showed that IPI, Ki-67, treatment modalities, Hans classification, Myc/Bcl-2 protein co-expression, and administration of rituximab had a significant effect on the 5-year OS and PFS ( P < 0.05), while age, sex, Bcl-2 protein expression, Myc protein expression, tumor stage, tumor size, Hashimoto's thyroiditis, and B symptoms were not associated with prognosis ( P > 0.05). Multivariate risk regression analysis revealed that Myc/Bcl-2 protein co-expression, treatment modalities, and rituximab were independent prognostic factors ( P < 0.05). Conclusions: Patients with primary thyroid DLBCL who received combination chemotherapy with radiotherapy had a better prognosis. Surgical treatment alone was not associated with the prognosis and is used only for diagnosis. Rituximab could improve the survival time of patients.

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Rituximab-Including Combined Modality Treatment for Primary Thyroid Lymphoma: An Effective Regimen for Elderly Patients

Cited by 21 publications

References 27 publications

Clinicopathological characteristics and treatment outcomes of 38 cases of primary thyroid lymphoma: a multicenter study

Clinicopathological characteristics and treatment outcomes of 38 cases of primary thyroid lymphoma: a multicenter study

Lymphomas and thyroid: Bridging the gap

A Multicenter Retrospective Study of 58 Patients With Primary Thyroid Diffuse Large B Cell Lymphoma

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