Clinicopathological analysis of primary adrenal diffuse large B-cell lymphoma: effectiveness of rituximab-containing chemotherapy including central nervous system prophylaxis

Experimental Hematology & Oncology

Hideo Harigae²  Ryo Ichinohasama³  Kenichi Ishizawa⁶  Osamu Fukuhara¹  Jun Nomura⁷  Osamu Sasaki⁴  Joji Yamamoto³  Yasushi Onishi⁶  Yuna Katsuoka⁶  Rie Ohba⁶  Hiroki Katsushima⁵  Ai Inoue⁶  Noriko Fukuhara⁶  Satoshi Ichikawa⁶ 

[1] Department of Internal Medicine, Sendai Red Cross Hospital, Sendai, Japan;Department of Molecular Hematology/Oncology, Tohoku University Graduate School of Medicine, Sendai, Japan;Department of Internal Medicine, Sendai City Hospital, Sendai, Japan;Department of Hematology, Miyagi Prefectural Cancer Center, Sendai, Japan;Department of Hematopathology, Tohoku University Graduate School of Medicine, Sendai, Japan;Department of Hematology and Rheumatology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-cho, Sendai 980-8574, Japan;Department of Internal Medicine, NTT East Tohoku Hospital, Sendai, Japan

关键词: Rituximab;    Central nervous system infiltration;    Adrenal insufficiency;    Diffuse large B-cell lymphoma;    Primary adrenal lymphoma;   

Others  :  812128
DOI  :  10.1186/2162-3619-2-19

 received in 2013-06-20, accepted in 2013-07-31,  发布年份 2013

【 摘 要 】

Background

Primary adrenal lymphoma (PAL) is an extremely rare subtype of extranodal non-Hodgkin’s lymphoma. Some researchers have reported some of the characteristics of PAL and its association with poor prognosis; however, the clinicopathological features of PAL remain to be elucidated.

Methods

From 2008 to 2011 we experienced seven cases of PAL in our institutions. We retrospectively analyzed the clinical and pathological features of these patients.

Results

The patients ranged in age from 50 to 85 years, with a median of 71 years. The overall male:female ratio was 6:1. All seven patients were diagnosed with diffuse large B-cell lymphoma (DLBCL) pathologically. Bilateral adrenal involvement was confirmed in five patients. The median largest tumor diameter at diagnosis was 58 mm. The Ki-67 index was generally high (>70%). All patients were treated with rituximab-containing chemotherapy, and central nervous system (CNS) prophylaxis was conducted for three patients. One patient with CNS involvement at the time of the diagnosis also received whole-brain radiation. The overall survival rate at two years was 57% (median follow-up; 24.8 months). It is noteworthy that the three patients who received a full course of the rituximab-containing regimen and CNS prophylaxis are currently alive without disease relapse, and that none of the seven patients died due to progression of lymphoma.

Conclusions

Primary adrenal DLBCL can be a clinically aggressive disease entity. Rituximab-containing chemotherapy combined with CNS prophylaxis could be a reasonable option for the treatment of PAL; however, analyses of more PAL cases are needed for the establishment of this strategy.

【 授权许可】

   
2013 Ichikawa et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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