T-cell/histiocyte-rich B-cell lymphoma: Clinical presentation, management and prognostic factors: report on 61 patients and review of literature

Abstract

T-cell/histiocyte-rich B-cell lymphoma (TC/HRBCL) is a rare subtype of diffuse large B-cell non-Hodgkin's lymphoma (DLBCL) with characteristic morphologic and immunophenotypic features, often misdiagnosed as Hodgkin's lymphoma and peripheral T-cell lymphoma. Few and conflicting clinical data are available in the literature addressing optimal treatment, prognosis and outcome. We retrospectively reviewed all patients diagnosed and managed at our institution between 1995 and 2004 diagnosed with T-cell-rich-B-cell lymphoma by WHO criteria. Sixty-one patients were identified. Initial pathology was incorrect in 82% of referred cases. The median age was 30 years. Seventy-one patients were males. Stage distribution was I - II in 21 patients, and III - IV in 40. Fifty-two percent of patients (32) had splenic involvement and thirty-seven patients (61%) presented with extranodal disease (22 >or= 2 sites). The International Prognostic Index (IPI) score was >or=2 in 62% of patients. All 59 newly diagnosed TC/HRBCL patients were treated with CHOP or R-CHOP combination chemotherapy +/- radiation therapy. The overall response rate was 85% and nine patients progressed on therapy. Fourteen patients relapsed with a median time of relapse of 6 months (range, 2 - 28). At a median follow-up of 22 months (range 1 - 132); 32 patients (52%) are alive with no evidence of disease. The 5-year overall survival and event free survival rates were 46% and 39% respectively. To conclude, TC/HRBCL is difficult to recognize without immunohistochemistry. It has an aggressive course and poor outcome; with most of patients presenting with advanced disease stage together with high IPI score. Treatment outcome seems to be similar to IPI matched DLBCL counterpart.

Practical Applications in Immunohistochemistry: Evaluation of Diffuse Large B-Cell Lymphoma and Related Large B-Cell Lymphomas

“…[58][59][60] It is a rare large B-cell lymphoma. It is most commonly seen in middle-aged men, and is associated with an aggressive clinical course.…”

Matched-Pair Analysis Comparing the Outcomes of T Cell/Histiocyte-Rich Large B Cell Lymphoma and Diffuse Large B Cell Lymphoma in Patients Treated with Rituximab-CHOP

“…Although most studies included a relatively small number of patients and were of a retrospective nature, similar outcomes of THRLBCL to that of DLBCL were demonstrated [1,9,10,11,15]. In particular, two case-control studies, which demonstrated no significant difference in OS between THRLBCL and DLBCL, showed CR rates of 52-63% and 3- or 5-year OS of 58-64% for THRLBCL [1,9].…”

“…The clinical presentation of THRLBCL is somewhat different from that of DLBCL-NOS. Thus, it predominantly affects middle-aged males and presents with advanced Ann Arbor stage involving the liver, spleen and bone marrow more frequently than DLBCL-NOS [1,8,9,10,11,12]. However, it is still not clear whether THRLBCL shows a different treatment outcome compared to DLBCL-NOS owing to its pathologic obscurity and extremely rare incidence.…”

“…However, it is still not clear whether THRLBCL shows a different treatment outcome compared to DLBCL-NOS owing to its pathologic obscurity and extremely rare incidence. As a result, there has been discrepancy about treatment outcomes of THRLBCL in previous studies [1,9,10,11,12,13,14,15]. Furthermore, treatment outcomes of THRLBCL with rituximab, an anti-CD20 monoclonal antibody, in combination with cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP) have not been compared with DLBCL even though R-CHOP is widely used as a standard chemotherapy for DLBCL and its variants.…”

Distribution, Arrangement and Interconnectedness of Cell Surface Receptor sites in the body of an Organism

“…This is an indication that dihydroartemisinin interacted with cell surface receptors on the parasite membrane. A number of studies have connected the development of organ toxicity (Tripathi et al, 2010) and cancer to certain receptors (Sato et al, 2005;Seggewiss et al, 2008;Weshi et al, 2007;Mustjoki et al, 2007;Filipovich et al, 1994;Suzuki et al, 2005;Galustian et al, 2009;Farag et al, 2002;Morre et al, 2008). These receptors involved in organ toxicity; in cancer or in other body disorders/diseases are cell surface receptors (UtohNedosa and .…”