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Diffuse large B-cell lymphoma:clinical feature and outcome of the Waldeyer's ring versus nodal presentation

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Author:
No author available
Journal Title:
CHINESE JOURNAL OF RADIATION ONCOLOGY
Issue:
1
DOI:
10.3760/cma.j.issn.1004-4221.2009.01.007
Key Word:
淋巴瘤,B细胞;淋巴瘤,大细胞,弥漫性;淋巴瘤,结内;淋巴瘤,结外;Lymphoma,B-cell;Lymphoma,large-cell,diffuse;Lymphoma,nodal;Lympboma,extranodal

Abstract: Objective To analyze clinical characteristics of diffuse large B-cell lymphonma(DL BCL) of Waldeyer's ring(WR-DLBCL) comparing with those of nodal DLBCL(N-DLBCL).Methods 181 patients consecutively diagnosed as primary WR-DLBCL(80) or N-DLBCL(101) were retrospectively reviewed.According to Ann Arbor staging system,57,83,26 and 15 patients had stage Ⅰ ,Ⅱ ,Ⅲ and Ⅳ disease,respectively.Patients with stageⅠ-Ⅱ disease were treated with chemotherapy and radiotherapy, whereas patients with stage Ⅲ-Ⅳ disease received primary chemotherapy. Results Comparing with N-DL BCL,pafients with WR-DLBCL presented with more stage Ⅱdiseases,more frequent involvement of adjacent organs and tissues,less B-symptoms,less involvement of spleen and lower lactate dehydrogenase (LDH) and β2-microglobulin(β2M) level.The 5-year overall survival(OS) rate of all patients was 76% for WR-DLBCL and 56% for N-DLBCL(x2 =2.43,P=0.119) ,respectively.The corresponding OS rate for stage Ⅰ and Ⅱ diseases was 78% for WR-DLBCL and 58% for N-DLBCL(X2 = 2.76,P =0.097),respectively.On univa riate analysis,elevated LDH,IPI and elevated β2 M were prognostic predictors for WR-DLBCL patients, whereas elevated β2 M,bulky tumor and IPI were associated with poor OS for N-DLBCL patients.On multiva riate analysis,elevated LDH and β2M were prognostic predictors for all patients. Conclusions Comparing with N-DLBCL,WR-DLBCL represents distinct clinical features and prognosis.

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