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T-Cell/Histiocyte-Rich Large B-Cell Lymphomas and Classical Diffuse Large B-Cell Lymphomas Have Similar Outcome After Chemotherapy: A Matched-Control Analysis

R. Bouabdallah, N. Mounier, C. Guettier, T. Molina, V. Ribrag, C. Thieblemont, A. Sonet, A. Delmer, K. Belhadj, P. Gaulard, C. Gisselbrecht, L. Xerri

From the Cancer Center Institut Paoli-Calmettes-Université de la Méditerranée, Marseille; Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Louis; Hôpital Paul Brousse; and Hôpital Hôtel Dieu, Paris; Institut Gustave Roussy, Villejuif; Hospices civils de Lyon, Lyon; Hôpital Henri Mondor, Créteil, France; and Université catholique de Louvain, Ivoir, Belgium.

Address reprint requests to Réda Bouabdallah, MD, Department of Hematology, Institut J. Paoli-I. Calmettes, 232 Boulevard Sainte-Marguerite, 13 273 Marseille Cédex 09; email: hemato1{at}marseille.fnclcc.fr.

Purpose: Because it is unclear whether T-cell/histiocyte-rich large B-cell lymphomas (H/TCRBCL) should be considered as a true clinicopathologic entity, we conducted a matched-control analysis comparing patients with H/TCRBCL and patients with diffuse large-B cell lymphoma (B-DLCL).

Patients and Methods: More than 4,500 patients were enrolled onto non-Hodgkin’s lymphoma trials conducted by the Groupe d’Etude des Lymphomes de l’Adulte. After histologic review, 50 patients were subclassified as H/TCRBCL. They were matched to 150 patients with B-DLCL for each of the factors of the International Prognostic Index (IPI).

Results: Clinical characteristics of H/TCRBCL patients showed a male predominance and a median age of 47 years. Performance status was normal in 89% of patients, whereas lactate dehydrogenase level was increased in 60% of patients. The disease was disseminated in 81% of patients, and 48% had two or more involved extranodal sites. The IPI score was 2 in 53% of patients. The complete response rate to chemotherapy was 63%, and 5-year overall survival (OS) and event-free survival (EFS) rates (mean ± SD) were 58% ± 18% and 53% ± 16%, respectively. The matched-control analysis showed a trend toward a better response to chemotherapy for patients with B-DLCL (P = .06), whereas no difference was observed in OS (P = .9) and EFS (P = .8).

Conclusion: H/TCRBCL is an aggressive disease that often presents with adverse prognostic factors. However, when treatment is adapted to the disease risk, outcome is equivalent to that observed in patients with B-DLCL. Thus H/TCRBCL should be considered a pathologic variant that belongs to the B-DLCL category.

Supported by grants from the Ministère de la Santé (Programme Hospitalier pour la Recherche Clinique [PHRC] Appel d’Offre Ministériel [AOM] grant no. 95061, PHRC LNH98 AOM grant no. 98.117), Assistance Publique Hôpitaux de Paris, France, and grants from Amgen-Roche, Neuilly sur Seine, France.

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