Abstract
BackgroundThe objective of this study was to identify prognostic factors for survival in patients with primary diffuse large B-cell lymphoma (DLBCL) of the adrenal gland.MethodsThirty one patients diagnosed with primary adrenal DLBCL from 14 Korean institutions and treated with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone) were analyzed.ResultsComplete remission (CR) and overall response rate after R-CHOP chemotherapy were 54.8% and 87.0%. The 2-year estimates of overall survival (OS) and progression-free survival (PFS) were 68.3% and 51.1%. In patients achieving CR, significant prolongations of OS (P = 0.029) and PFS (P = 0.005) were observed. Ann Arbor stage had no influence on OS. There was no significant difference in OS between patients with unilateral involvement of adrenal gland and those with bilateral involvement. When staging was modified to include bilateral adrenal involvement as one extranodal site, early stage (I or II) significantly correlated with longer OS (P = 0.021) and PFS (P <0.001).ConclusionsContrary to prior reports, our data suggests that outcomes of primary adrenal DLBCL are encouraging using a regimen of R-CHOP, and that achieving CR after R-CHOP is predictive of survival. Likewise, our modified staging system may have prognostic value.
Highlights
The objective of this study was to identify prognostic factors for survival in patients with primary diffuse large B-cell lymphoma (DLBCL) of the adrenal gland
It is unclear whether R-CHOP truly improve the treatment outcomes in these patients, a few reports show that major improvement is possible [5,11]
Because of the poor performance status (PS), 12.8% (5/39) of patients with DLBCL did not received chemotherapy. Another 7.6% (3/39) of patients were treated with a CHOP regimen, prior to the advent of rituximab
Summary
The objective of this study was to identify prognostic factors for survival in patients with primary diffuse large B-cell lymphoma (DLBCL) of the adrenal gland. The patients with primary adrenal DLBCL had been treated with CHOP (cyclophosphamide, doxorubicin, vincristine and prednisone) like chemotherapy before rituximab era and central nerve system (CNS) relapse was frequent [10]. At present, it is unclear whether R (rituximab)-CHOP truly improve the treatment outcomes in these patients, a few reports show that major improvement is possible [5,11]. Further studies with a larger number of patients are warranted
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