This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Daum, S. Articles by Riecken, E.-O. Search for Related Content PubMed PubMed Citation Articles by Daum, S. Articles by Riecken, E.-O. Related Articles Related Correspondence

Intestinal Non-Hodgkin’s Lymphoma: A Multicenter Prospective Clinical Study From the German Study Group on Intestinal Non-Hodgkin’s Lymphoma

Severin Daum, Reiner Ullrich, Walter Heise, Bettina Dederke, Hans-Dieter Foss, Harald Stein, Eckhard Thiel, Martin Zeitz, Ernst-Otto Riecken

From the Department of Medicine I (Gastroenterology, Infectious Diseases and Rheumatology), the Institute of Pathology, the Department of Medicine II (Hematology, Oncology and Transfusion Medicine), Universitätsklinikum Benjamin Franklin, Free University of Berlin; and the Medical Department, Auguste Viktoria-Krankenhaus, Berlin, Germany.

Address reprint requests to Severin Daum, MD, Department of Medicine I, Universitätsklinikum Benjamin Franklin, Hindenburgdamm 30, D-12200 Berlin, Germany; email: severin.daum{at}medizin.fu-berlin.de.

Purpose: Intestinal non-Hodgkin’s lymphomas are not well characterized. We therefore studied prospectively their clinical features and response to standardized therapy.

Patients and Methods: Fifty-six patients with primary intestinal lymphoma were included in a prospective, nonrandomized multicenter study. Lymphoma resection was recommended and staging was performed according to the Ann Arbor classification. Patients were scheduled to receive six cycles of cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP) chemotherapy, and at stages EIII to EIV, they received additional involved-field radiotherapy. Corticosteroids were used in patients who could not receive chemotherapy.

Results: Thirty-five patients had intestinal T-cell lymphoma (ITCL), 21 patients had intestinal B-cell lymphoma (IBCL; 18 diffuse large-cell lymphomas, two marginal-cell lymphomas, and one follicle-center lymphoma). Thirty-four patients at stages EI to EII (14 ITCL and 20 IBCL) and nine patients at stages EIII to EIV (all ITCL) received chemotherapy. No patient in stages EIII to EIV received radiotherapy, because death occurred in 12 of 14 patients. Two-year cumulative survival in patients with IBCL was 94% (95% CI, 82% to 100%) and higher than in patients with ITCL (28% [95% CI, 13% to 43%]; P < .0001), even when only stages EI to EII were considered (ITCL, 37.5% [95% CI, 16.5% to 58.5%]; P < .0001). IBCL patients compared with ITCL patients were at lower lymphoma stages (P < .01), had higher Karnofsky status (P < .005), had intestinal perforation less often (P < .05), required emergency operation less often (P < .05), received CHOP (P < .05) more often, and reached complete remission (P < .0005) more frequently.

Conclusion: IBCL patients at stages EI and EII respond well to chemotherapy, but the prognosis and treatment of ITCL patients is unsatisfactory.

Severin Daum and Reiner Ullrich contributed equally to this work.

Related Correspondence

• Intestinal Non-Hodgkin's Lymphoma
  P. Koch, R. Liersch, and W.E. Berdel
  JCO 2004 22: 2752-2753 [Full Text]

This article has been cited by other articles:

				A Al-toma, W H M Verbeek, M Hadithi, B M E von Blomberg, and C J J Mulder Survival in refractory coeliac disease and enteropathy-associated T-cell lymphoma: retrospective evaluation of single-centre experience Gut, October 1, 2007; 56(10): 1373 - 1378. [Abstract] [Full Text] [PDF]

				A. Al-toma, O. J. Visser, H. M. van Roessel, B. M. E. von Blomberg, W. H. M. Verbeek, P. E. T. Scholten, G. J. Ossenkoppele, P. C. Huijgens, and C. J. J. Mulder Autologous hematopoietic stem cell transplantation in refractory celiac disease with aberrant T cells Blood, March 1, 2007; 109(5): 2243 - 2249. [Abstract] [Full Text] [PDF]

				T. R. Halfdanarson, M. R. Litzow, and J. A. Murray Hematologic manifestations of celiac disease Blood, January 15, 2007; 109(2): 412 - 421. [Abstract] [Full Text] [PDF]

				S. Wohrer, A. Chott, J. Drach, A. Puspok, M. Hejna, M. Hoffmann, and M. Raderer Chemotherapy with cyclophosphamide, doxorubicin, etoposide, vincristine and prednisone (CHOEP) is not effective in patients with enteropathy-type intestinal T-cell lymphoma Ann. Onc., November 1, 2004; 15(11): 1680 - 1683. [Abstract] [Full Text] [PDF]

				S. Daum, R. Ullrich, and M. Zeitz In Reply: J. Clin. Oncol., July 1, 2004; 22(13): 2753 - 2754. [Full Text] [PDF]

				P. Koch, R. Liersch, and W.E. Berdel Intestinal Non-Hodgkin's Lymphoma J. Clin. Oncol., July 1, 2004; 22(13): 2752 - 2753. [Full Text]