Prognostic factors in primary diffuse large B-cell lymphoma of adrenal gland treated with rituximab-CHOP chemotherapy from the Consortium for Improving Survival of Lymphoma (CISL)
1 Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
2 Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
3 Pusan National University Hospital, Busan, Korea
4 Ewha Womans University School of Medicine, Seoul, Korea
5 Korea University College of Medicine, Seoul, Korea
6 Keimyung University School of Medicine, Daegu, Korea
7 Ajou University School of Medicine, Suwon, Korea
8 Dong-A University College of Medicine, Busan, Korea
9 Chung-Ang University Hospital, Seoul, Korea
10 Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
11 National Cancer Center, Goyang, Korea
12 Chonnam National University Hwasun Hospital, Hwasun, Jeollanamdo, Korea
13 Kyung Hee University Medical Center, Seoul, Korea
14 Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
15 Department of Internal Medicine, Division of Hematology, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Korea
Journal of Hematology & Oncology 2012, 5:49 doi:10.1186/1756-8722-5-49Published: 13 August 2012
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.
Thirty one patients diagnosed with primary adrenal DLBCL from 14 Korean institutions and treated with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone) were analyzed.
Complete 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).
Contrary 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.