DLBCL: abdominal lymph node involvement linked to inferior lymphoma-specific survival

  • Abdulla M & al.
  • Eur J Haematol
  • 30 Nov 2019

  • curated by David Reilly
  • Univadis Clinical Summaries
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Takeaway

  • Patients with diffuse large B-cell lymphoma (DLBCL) and abdominal lymph node involvement had inferior lymphoma-specific survival (LSS) and more characteristics associated with aggressive disease vs those without abdominal nodal involvement.

Why this matters

  • Outcomes with various sites of extranodal DLBCL have been well studied, but less is known regarding sites of nodal involvement.

Study design

  • Study to investigate the prognostic implications of abdominal lymph node involvement in 249 patients with de novo DLBCL.
  • All patients had been treated with R-CHOP (rituximab, cyclophosphamide, adriamycin, vincristine, and prednisone) or similar regimens.
  • Patient age range, 26-86 years.
  • Funding: None disclosed.

Key results

  • 63% of patients with DLBCL had abdominal nodal disease.
  • Compared with patients without abdominal lymph node involvement, those with abdominal nodal disease had:
    • Inferior LSS: HR, 1.79 (95% CI, 1.01-3.17; P=.04).
    • Higher age-adjusted international prognostic index (IPI) scores: 65% with IPI 2-3 vs 27% (P<.001>
    • High lactate dehydrogenase: 69% vs 44% (P<.001>
    • Greater frequency of advanced-stage disease: 72% with stage III-IV disease vs 31% (P<.001>
    • Greater frequency of bulky disease: 33% vs 10% (P<.001>
    • Greater frequency of B symptoms: 50% vs 26% (P<.001>

Limitations

  • Retrospective data.