Survival of patients with CD20-negative variants of large B-cell lymphoma: an analysis of the National Cancer Data Base

Abstract

Using records from the National Cancer Data Base, we studied overall survival of CD20-negative variants of diffuse large B-cell lymphoma (DLBCL): primary effusion (PEL, N = 228), plasmablastic (PBL, N = 481), ALK-positive large B-cell (ALK + LBLC, N = 15), and human herpesvirus-8-positive DLBCL (HHV8 + DLBCL, N = 77). Three-year survival was 27% for PEL, 40% for PBL, 34% for ALK + LBCL, and 63% for HHV8 + DLBCL. Compared with unspecified DLBCL, and adjusting for clinical characteristics (including the HIV status), survival was significantly worse for PEL (hazard ratio [HR], 1.58; 95% confidence interval [CI], 1.31-1.90), PBL (HR 1.66; 95% CI, 1.41-1.95), and ALK + LBCL (HR, 2.70; 95% CI, 1.27-5.75), but not for HHV8 + DLBCL (HR, 0.89; 95% CI, 0.54-1.45). The HIV status was not an independent prognostic factor in PEL, PBL, or HHV8 + DLBCL. Advanced stage was prognostic for PBL (p = .0002), but not for ALK + LBCL (p = .96), or HHV8 + DLBCL (p = .28). In PEL and PBL survival significantly differed according to primary site. Novel therapeutic approaches are urgently needed for these rare diseases.

Survival analysis in treated plasmablastic lymphoma patients: a population‐based study

“…Concordantly, HIV was reported in 52.7% of our patients with known HIV infection status. It is unclear whether HIV infection has a prognostic value in PBL patients based on conflicting data in the literature reporting either no difference in OS 11,13,20 or better unadjusted survival in HIV positive patients 9,12 . Herein we show no difference in OS and LSS between HIV positive and negative patients in both univariable and multivariable analyses, suggesting that HIV status does not affect survival of PBL patients, as it was also recently reported in DLBCL 30‐32 …”

“…Since its description as a new entity in 1997, few case series of PBL have been reported 6,9,11‐13 . The largest reported cohort of 481 patients was based on the analysis of the National Cancer Data Base 20 . However, to the best of our knowledge, our analysis represents the first population‐based study of PBL patients using the SEER database in chemotherapy‐treated patients with PBL.…”

Diffuse large B-cell lymphoma variants: an update

“…12,13 The 5-year overall survival (OS) is 34% with a median survival of 1.8 years. [12][13][14] Patients younger than 35 years show a better OS compared with patients older than 35 years. 12 Patients with low-stage disease have a better prognosis.…”

“…1 Epidemiology HHV8+ DLBCL is a rare disease with an overall frequency of 0.1%. 14 The median age of patients is 47 years (range 39-66 years) with a male:female ratio of 3.3:1. 14,22 Approximately 50% of patients are HIV+.…”

“…14 The median age of patients is 47 years (range 39-66 years) with a male:female ratio of 3.3:1. 14,22 Approximately 50% of patients are HIV+. Patients with HIV+ HHV8+ multicentric Castleman disease are at 15-times higher risk for developing HHV8+ DLBCL.…”