Originally published as JCO Early Release 10.1200/JCO.2005.07.155 on February 22 2005

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 Rights & Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by López-Guillermo, A. Articles by Montserrat, E. Search for Related Content PubMed PubMed Citation Articles by López-Guillermo, A. Articles by Montserrat, E. Social Bookmarking                            What's this?

Diffuse Large B-Cell Lymphoma: Clinical and Biological Characterization and Outcome According to the Nodal or Extranodal Primary Origin

From the Departments of Hematology and Pathology, Hospital Clínic, Institut de Recerca Biomèdica August Pi i Sunyer, Barcelona, Spain

Address reprint requests to A. López-Guillermo, MD; Department of Hematology, Hospital Clínic, Villarroel 170, 08036 Barcelona, Spain; e-mail: alopezg{at}clinic.ub.es

PURPOSE: To study the main clinicobiologic features, response, and outcome of patients with diffuse large B-cell lymphoma (DLBCL) according to the primary site, lymph node, or different extranodal organs of the disease.

PATIENTS AND METHODS: We included 382 patients consecutively diagnosed with DLBCL in a single institution during a 13-year period. Morphology, immunophenotyping, proliferation index, differentiation profile, bcl-2/JH rearrangement, and clinical characteristics were analyzed according to the primary site of the lymphoma.

RESULTS: Sites of the disease were: lymph node, 222 cases (58%); Waldeyer's ring (WR), 42 (11%); and extranodal sites, 118 (31%), including GI tract in 45 cases. Primary extranodal cases, particularly GI, showed a bcl-6 expression more frequently than nodal cases. Patients with primary WR or GI lymphomas presented with early-stage disease, no marrow infiltration, normal serum lactate dehydrogenase, and low- to low/intermediate-risk international prognostic index (IPI) more frequently than the remainder. Complete response (CR) rate was 63%, with WR and GI lymphomas having a higher CR rate (85% and 80%, respectively) than the other groups. In the whole series, 5-year overall survival (OS) was 52%. Patients with WR or GI lymphomas showed better OS (5-year OS: 77% and 68%, respectively) than patients with nodal or other extranodal sites. In the multivariate analysis, IPI, bulky disease, and ß2-microglobulin were the main variables to predict OS; no nodal or extranodal site maintained their prognostic value.

CONCLUSION: In the present series, the primary site of disease was associated with particular clinicopathologic features and outcome, though the latter largely depended on other factors.

Supported by grants FIS-IP03/0473, Spanish Ministry of Health; "Red de Centros de Investigación del Cáncer y de Grupos para el Estudio de Linfomas, Instituto Carlos III–FIS", and the José Carreras Foundation Against Leukemia (EM-P/04 and CR-P/04).

Authors' disclosures of potential conflicts of interest are found at the end of this article.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				J Craig, K Walker, L Bayer, J Brunton, B Oliver, D Meiklejohn, N Kernohan, and S Tauro Multifocal primary extranodal B-cell non-Hodgkin's lymphoma involving six extranodal sites J. Clin. Pathol., January 1, 2009; 62(1): 89 - 91. [Abstract] [Full Text] [PDF]

				G. Ryan, G. Martinelli, M. Kuper-Hommel, R. Tsang, G. Pruneri, K. Yuen, D. Roos, A. Lennard, L. Devizzi, S. Crabb, et al. Primary diffuse large B-cell lymphoma of the breast: prognostic factors and outcomes of a study by the International Extranodal Lymphoma Study Group Ann. Onc., February 1, 2008; 19(2): 233 - 241. [Abstract] [Full Text] [PDF]