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Primary diffuse large B-cell lymphoma of the breast: prognostic factors and outcomes of a study by the International Extranodal Lymphoma Study Group

Primary diffuse large B-cell lymphoma of the breast: prognostic factors and outcomes of a study by the International Extranodal Lymphoma Study Group
Primary diffuse large B-cell lymphoma of the breast: prognostic factors and outcomes of a study by the International Extranodal Lymphoma Study Group
Background: Primary diffuse large B-cell lymphoma (DLBCL) of breast is rare. We aimed to define clinical features, prognostic factors, patterns of failure, and treatment outcomes. Patients and methods: A retrospective international study of 204 eligible patients presenting to the International Extranodal Lymphoma Study Group-affiliated institutions from 1980 to 2003. Results: Median age was 64 years, with 95% of patients presenting with unilateral disease. Median overall survival (OS) was 8.0 years, and median progression-free survival 5.5 years. In multifactor analysis, favourable International Prognostic Index score, anthracycline-containing chemotherapy, and radiotherapy (RT) were significantly associated with longer OS (each P <= 0.03). There was no benefit from mastectomy, as opposed to biopsy or lumpectomy only. At a median follow-up time of 5.5 years, 37% of patients had progressed-16% in the same or contralateral breast, 5% in the central nervous system, and 14% in other extranodal sites. Conclusions: The combination of limited surgery, anthracycline-containing chemotherapy, and involved-field RT produced the best outcome in the pre-rituximab era. A prospective trial on the basis of these results should be pursued to confirm these observations and to determine whether the impact of rituximab on the patterns of relapse and outcome parallels that of DLBCL presenting at other sites
lymphoma, non-hodgkins-lymphoma, rituximab, outcomes, chemotherapy, female breast, large b-cell lymphoma, localized aggressive lymphoma, oncology-group, anthracycline-based chemotherapy, survival, surgery, breast, patterns, chop plus radiotherapy, elderly-patients, retrospective analysis, radiotherapy, disease
0923-7534
233-241
Ryan, G.
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Martinelli, G.
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Kuper-Hommel, M.
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Tsang, R.
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Pruneri, G.
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Yuen, K.
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Roos, D.
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Lennard, A.
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Devizzi, L.
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Crabb, S.
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Hossfeld, D.
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Pratt, G.
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Dell'Olio, M.
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Choo, S.P.
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Bociek, R.G.
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Radford, J.
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Lade, S.
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Gianni, A.M.
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Zucca, E.
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Cavalli, F.
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Seymour, J.F.
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Ryan, G.
d47f410f-8924-4a67-82a0-0187d859372a
Martinelli, G.
3949da7a-7efe-4ebd-b1f7-92f1ca150d66
Kuper-Hommel, M.
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Tsang, R.
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Pruneri, G.
393850a3-42e5-46bb-84e6-9d5889c69808
Yuen, K.
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Roos, D.
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Lennard, A.
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Devizzi, L.
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Crabb, S.
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Hossfeld, D.
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Pratt, G.
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Dell'Olio, M.
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Choo, S.P.
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Bociek, R.G.
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Radford, J.
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Lade, S.
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Gianni, A.M.
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Zucca, E.
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Cavalli, F.
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Seymour, J.F.
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Ryan, G., Martinelli, G., Kuper-Hommel, M., Tsang, R., Pruneri, G., Yuen, K., Roos, D., Lennard, A., Devizzi, L., Crabb, S., Hossfeld, D., Pratt, G., Dell'Olio, M., Choo, S.P., Bociek, R.G., Radford, J., Lade, S., Gianni, A.M., Zucca, E., Cavalli, F. and Seymour, J.F. (2008) Primary diffuse large B-cell lymphoma of the breast: prognostic factors and outcomes of a study by the International Extranodal Lymphoma Study Group. Annals of Oncology, 19 (2), 233-241. (doi:10.1093/annonc/mdm471).

Record type: Article

Abstract

Background: Primary diffuse large B-cell lymphoma (DLBCL) of breast is rare. We aimed to define clinical features, prognostic factors, patterns of failure, and treatment outcomes. Patients and methods: A retrospective international study of 204 eligible patients presenting to the International Extranodal Lymphoma Study Group-affiliated institutions from 1980 to 2003. Results: Median age was 64 years, with 95% of patients presenting with unilateral disease. Median overall survival (OS) was 8.0 years, and median progression-free survival 5.5 years. In multifactor analysis, favourable International Prognostic Index score, anthracycline-containing chemotherapy, and radiotherapy (RT) were significantly associated with longer OS (each P <= 0.03). There was no benefit from mastectomy, as opposed to biopsy or lumpectomy only. At a median follow-up time of 5.5 years, 37% of patients had progressed-16% in the same or contralateral breast, 5% in the central nervous system, and 14% in other extranodal sites. Conclusions: The combination of limited surgery, anthracycline-containing chemotherapy, and involved-field RT produced the best outcome in the pre-rituximab era. A prospective trial on the basis of these results should be pursued to confirm these observations and to determine whether the impact of rituximab on the patterns of relapse and outcome parallels that of DLBCL presenting at other sites

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More information

Published date: 2008
Keywords: lymphoma, non-hodgkins-lymphoma, rituximab, outcomes, chemotherapy, female breast, large b-cell lymphoma, localized aggressive lymphoma, oncology-group, anthracycline-based chemotherapy, survival, surgery, breast, patterns, chop plus radiotherapy, elderly-patients, retrospective analysis, radiotherapy, disease
Organisations: Medicine

Identifiers

Local EPrints ID: 62910
URI: http://eprints.soton.ac.uk/id/eprint/62910
ISSN: 0923-7534
PURE UUID: 44a0ad3d-0d94-4bb2-b0cb-afe90905cf54
ORCID for S. Crabb: ORCID iD orcid.org/0000-0003-3521-9064

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Date deposited: 04 Sep 2008
Last modified: 16 Mar 2024 03:32

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Contributors

Author: G. Ryan
Author: G. Martinelli
Author: M. Kuper-Hommel
Author: R. Tsang
Author: G. Pruneri
Author: K. Yuen
Author: D. Roos
Author: A. Lennard
Author: L. Devizzi
Author: S. Crabb ORCID iD
Author: D. Hossfeld
Author: G. Pratt
Author: M. Dell'Olio
Author: S.P. Choo
Author: R.G. Bociek
Author: J. Radford
Author: S. Lade
Author: A.M. Gianni
Author: E. Zucca
Author: F. Cavalli
Author: J.F. Seymour

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