Uterine, but not ovarian, female reproductive organ involvement at presentation by diffuse large B-cell lymphoma is associated with poor outcomes and a high frequency of secondary CNS involvement

Autor: Martin Bøgsted, Thomas Stauffer Larsen, Kirsty Rady, Diego Villa, John F. Seymour, Jakob Werner Hansen, Joseph M. Connors, Michael Roost Clausen, Peter D. Brown, Laurie H. Sehn, Chan Yoon Cheah, Martin Hutchings, Sabrina Cordua, Mette Østergaard Poulsen, Staffan Holmberg, Karen Juul Mylam, Tarec Christoffer El-Galaly, Kerry J. Savage, Kristina Buchardi Jensen, Sally F. Barrington, Daniel J. Smith, N. G. Mikhaeel, Maja Bech Juul, Hans Erik Johnsen
Rok vydání: 2016
Předmět:
Oncology
Adult
medicine.medical_specialty
positron emission tomography
Adolescent
Databases
Factual
Uterus
gynaecological involvement
Disease-Free Survival
Diffuse Large B cell Lymphoma
Central Nervous System Neoplasms
03 medical and health sciences
Young Adult
0302 clinical medicine
immune system diseases
Internal medicine
hemic and lymphatic diseases
medicine
central nervous system relaps
Humans
Young adult
Survival rate
Uterine Neoplasm
Aged
Retrospective Studies
Gynecology
Aged
80 and over
Ovarian Neoplasms
business.industry
Hazard ratio
Hematology
Middle Aged
medicine.disease
Prognosis
Lymphoma
Survival Rate
medicine.anatomical_structure
030220 oncology & carcinogenesis
Concomitant
uterus involvement
Uterine Neoplasms
Female
Lymphoma
Large B-Cell
Diffuse
business
Rituximab
Diffuse large B-cell lymphoma
030215 immunology
Zdroj: El-Galaly, T C, Cheah, C Y, Hutchings, M, Mikhaeel, N G, Savage, K J, Sehn, L H, Barrington, S, Hansen, J W, Poulsen, M Ø, Smith, D, Rady, K, Mylam, K J, Larsen, T S, Holmberg, S, Juul, M B, Cordua, S, Clausen, M R, Jensen, K B, Bøgsted, M, Johnsen, H E, Seymour, J F, Connors, J M, Brown, P D N & Villa, D 2016, ' Uterine, but not ovarian, female reproductive organ involvement at presentation by diffuse large B-cell lymphoma is associated with poor outcomes and a high frequency of secondary CNS involvement ', British Journal of Haematology, vol. 175, no. 5, pp. 876-883 . https://doi.org/10.1111/bjh.14325
El-Galaly, T C, Cheah, C Y, Hutchings, M, Mikhaeel, N G, Savage, K J, Sehn, L H, Barrington, S, Hansen, J W, Poulsen, M Ø, Smith, D, Rady, K, Juul Mylam, K, Larsen, T S, Holmberg, S, Juul, M B, Cordua, S, Clausen, M R, Jensen, K B, Bøgsted, M, Johnsen, H E, Seymour, J F, Connors, J M, Brown, P D N & Villa, D 2016, ' Uterine, but not ovarian, female reproductive organ involvement at presentation by diffuse large B-cell lymphoma is associated with poor outcomes and a high frequency of secondary CNS involvement ', British Journal of Haematology, vol. 175, no. 5, pp. 876-883 . https://doi.org/10.1111/bjh.14325
University of Western Australia
ISSN: 1365-2141
DOI: 10.1111/bjh.14325
Popis: Involvement of the internal female reproductive organs by diffuse large B-cell lymphoma (DLBCL) is uncommon, and there are sparse data describing the outcomes of such cases. In total, 678 female patients with DLBCL staged with positron emission tomography/computed tomography and treated with rituximab-containing chemotherapy were identified from databases in Denmark, Great Britain, Australia, and Canada. Overall, 27/678 (4%) had internal reproductive organ involvement: uterus (n = 14), ovaries (n = 10) or both (n = 3). In multivariate analysis, women with uterine DLBCL experienced inferior progression-free survival and overall survival compared to those without reproductive organ involvement, whereas ovarian DLBCL was not predictive of outcome. Secondary central nervous system (CNS) involvement (SCNS) occurred in 7/17 (41%) women with uterine DLBCL (two patients with concomitant ovarian DLBCL) and 0/10 women with ovarian DLBCL without concomitant uterine involvement. In multivariate analysis adjusted for other risk factors for SCNS, uterine involvement by DLBCL remained strongly associated with SCNS (Hazard ratio 14·13, 95% confidence interval 5·09-39·25, P < 0·001). Because involvement of the uterus by DLBCL appears to be associated with a high risk of SCNS, those patients should be considered for CNS staging and prophylaxis. However, more studies are needed to determine whether the increased risk of secondary CNS involvement also applies to women with localized reproductive organ DLBCL.
Databáze: OpenAIRE
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