Analysis of clinical characteristics and outcome of patients with previously untreated diffuse large B-cell lymphoma and renal involvement in the rituximab era

• Verfasst von: Giesen, Nicola [VerfasserIn]
• Verfasst von: Krämer, Isabelle [VerfasserIn]
• Verfasst von: Schwarzbich, Mark-Alexander [VerfasserIn]
• Verfasst von: Ho, Anthony Dick [VerfasserIn]
• Verfasst von: Witzens-Harig, Mathias [VerfasserIn]
• Titel: Analysis of clinical characteristics and outcome of patients with previously untreated diffuse large B-cell lymphoma and renal involvement in the rituximab era
• Verf.angabe: Nicola Lehners, Isabelle Krämer, Mark-Alexander Schwarzbich, Anthony D. Ho & Mathias Witzens-Harig
• E-Jahr: 2016
• Jahr: 21 Mar 2016
• Umfang: 7 S.
• Fussnoten: Gesehen am 18.06.2020
• Titel Quelle: Enthalten in: Leukemia and lymphoma
• Ort Quelle: London [u.a.] : Taylor & Francis Group, 1989
• Jahr Quelle: 2016
• Band/Heft Quelle: 57(2016), 11, Seite 2619-2625
• ISSN Quelle: 1029-2403
• DOI: doi:10.3109/10428194.2016.1157869
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: chemotherapeutic approaches
• Sach-SW: lymphoma and Hodgkin disease
• Sach-SW: prognostication
• K10plus-PPN: 1701039729

Abstract

Renal involvement in patients with lymphoma is rare but associated with poor prognosis. We analyzed characteristics and outcome of 22 patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL) and renal involvement treated with a rituximab-containing regimen in curative intent. The majority of patients presented in advanced disease, 86% were Ann Arbor stage ≥ III and had an IPI score ≥ 3. Renal impairment was present in 32%. Outcome was poor with three-year progression-free survival (PFS) 44% and three-year overall survival (OS) 52% and significantly worse compared to DLBCL without renal involvement (p < 0.01). Patients with high-risk IPI had a significantly inferior prognosis compared to intermediate-risk IPI (three-year OS 0% vs. 75%, p = 0.01) as did those with renal impairment. A high rate of central nervous system (CNS) relapse (8/22) was observed. Intravenous high-dose methotrexate and intrathecal therapy showed a trend toward prolonged time to CNS relapse. Implementation of CNS prophylaxis might therefore be considered in these high-risk patients.