Concordant bone marrow involvement of diffuse large B-cell lymphoma represents a distinct clinical and biological entity in the era of immunotherapy
| Autor: | M. Ponzoni, Wayne Tam, J.H.J.M. van Krieken, Lijuan Deng, Praveen Jain, Luis Fayad, Jianxiang Wang, Govind Bhagat, Ganiraju C. Manyam, Hagop M. Kantarjian, L. J. Medeiros, Y Liu, Ken H. Young, Karen Dybkær, Jorge E. Cortes, C. Visco, Yong Li, Jane N. Winter, Zhilei Yao, Robert Z. Orlowski, Anna Ferreri, Alexandar Tzankov, Zijun Y. Xu-Monette, M A Piris, Eric D. Hsi, Yongping Song, Michael Boe Møller |
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| Přispěvatelé: | Yao, Z., Deng, L., Xu-Monette, Z. Y., Manyam, G. C., Jain, P., Tzankov, A., Visco, C., Bhagat, G., Wang, J., Dybkaer, K., Tam, W., Hsi, E. D., Van Krieken, J. H., Ponzoni, M., Ferreri, A. J. M., Moller, M. B., Winter, J. N., Piris, M. A., Fayad, L., Liu, Y., Song, Y., Orlowski, R. Z., Kantarjian, H., Medeiros, L. J., Li, Y., Cortes, J., Young, K. H. |
| Rok vydání: | 2017 |
| Předmět: |
Male
Oncology Cancer Research Pathology Lymphoma Cancer development and immune defence Radboud Institute for Molecular Life Sciences [Radboudumc 2] medicine.medical_treatment 0302 clinical medicine International Prognostic Index Bone Marrow hemic and lymphatic diseases Antineoplastic Combined Chemotherapy Protocols 80 and over Stage (cooking) Aged 80 and over Bone Marrow/drug effects Hematology Middle Aged Prognosis Diffuse Lymphoma Large B-Cell Diffuse/drug therapy medicine.anatomical_structure 030220 oncology & carcinogenesis Immunotherapy/methods Female Rituximab Immunotherapy Lymphoma Large B-Cell Diffuse Adolescent Adult Aged Disease-Free Survival Humans Immunologic Factors Young Adult medicine.drug medicine.medical_specialty Article 03 medical and health sciences All institutes and research themes of the Radboud University Medical Center Internal medicine Large B-Cell medicine Performance status business.industry medicine.disease Antineoplastic Combined Chemotherapy Protocols/therapeutic use Bone marrow business Immunologic Factors/metabolism Diffuse large B-cell lymphoma 030215 immunology |
| Zdroj: | Leukemia, 32, 353-363 Yao, Z, Deng, L, Xu-Monette, Z Y, Manyam, G C, Jain, P, Tzankov, A, Visco, C, Bhagat, G, Wang, J, Dybkaer, K, Tam, W, Hsi, E D, van Krieken, J H, Ponzoni, M, Ferreri, A J M, Møller, M B, Winter, J N, Piris, M A, Fayad, L, Liu, Y, Song, Y, Orlowski, R Z, Kantarjian, H, Medeiros, L J, Li, Y, Cortes, J & Young, K H 2018, ' Concordant bone marrow involvement of diffuse large B-cell lymphoma represents a distinct clinical and biological entity in the era of immunotherapy ', Leukemia, vol. 32, no. 2, pp. 353-363 . https://doi.org/10.1038/leu.2017.222 Leukemia, 32, 2, pp. 353-363 Yao, Z, Deng, L, Xu-Monette, Z Y, Manyam, G C, Jain, P, Tzankov, A, Visco, C, Bhagat, G, Wang, J, Dybkær, K, Tam, W, Hsi, E D, van Krieken, J H, Ponzoni, M, Ferreri, A J M, Møller, M B, Winter, J N, Piris, M A, Fayad, L, Liu, Y, Song, Y, Orlowski, R Z, Kantarjian, H, Medeiros, L J, Li, Y, Cortes, J & Young, K H 2018, ' Concordant bone marrow involvement of diffuse large B-cell lymphoma represents a distinct clinical and biological entity in the era of immunotherapy ', Leukemia, vol. 32, no. 2, pp. 353–363 . https://doi.org/10.1038/leu.2017.222 |
| ISSN: | 1476-5551 0887-6924 |
| Popis: | In diffuse large B-cell lymphoma (DLBCL), the clinical and biological significance of concordant and discordant bone marrow (BM) involvement have not been well investigated. We evaluated 712 de novo DLBCL patients with front-line rituximab-containing treatment, including 263 patients with positive and 449 with negative BM status. Compared with negative BM disease, concordant BM adversely impacted overall and progression-free survival, independent of the International Prognostic Index (IPI) and cell-of-origin classification. Once BM is concordantly involved, poor prognosis was not associated with the extent of BM involvement. Conversely, patients with discordant BM showed favorable overall survival similar to stage I-II DLBCL. A BM-adjusted IPI, using three parameters: concordant BM involvement, age >60 years, and performance status >1, improves the risk stratification for DLBCL with positive BM. Intensive immunochemotherapy seemingly rendered survival benefit for patients with concordant BM, as did rituximab maintenance for the discordant BM group. Frequently revealing adverse clinical and molecular characteristics, patients with concordant BM demonstrated gene expression signatures relevant to tumor cell proliferation, migration and immune escape. In conclusion, clinical and biological heterogeneity is seen in DLBCL with positive BM but concordant BM involvement represents a distinct subset with unfavorable gene signatures, high-risk clinicopathologic features and poor prognosis. |
| Databáze: | OpenAIRE |
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