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
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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. / El-Galaly, Tarec Christoffer; Cheah, Chan Y; Hutchings, Martin; Mikhaeel, Nabegh George; Savage, Kerry J; Sehn, Laurie H; Barrington, Sally F; Hansen, Jakob W; Poulsen, Mette Ø; Smith, Daniel L; Rady, Kirsty; Mylam, Karen Juul; Larsen, Thomas S; Holmberg, Staffan; Juul, Maja B; Cordua, Sabrina ; Clausen, Michael Roost; Jensen, Kristina B; Boegsted, Martin; Johnsen, Hans E; Seymour, John F; Connors, Joseph M; Brown, Peter D N; Villa, Diego.
In: British Journal of Haematology, Vol. 175, No. 5, 12.2016, p. 876-883.Research output: Contribution to journal › Journal article › Research › peer-review
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T1 - 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
AU - El-Galaly, Tarec Christoffer
AU - Cheah, Chan Y
AU - Hutchings, Martin
AU - Mikhaeel, Nabegh George
AU - Savage, Kerry J
AU - Sehn, Laurie H
AU - Barrington, Sally F
AU - Hansen, Jakob W
AU - Poulsen, Mette Ø
AU - Smith, Daniel L
AU - Rady, Kirsty
AU - Mylam, Karen Juul
AU - Larsen, Thomas S
AU - Holmberg, Staffan
AU - Juul, Maja B
AU - Cordua, Sabrina
AU - Clausen, Michael Roost
AU - Jensen, Kristina B
AU - Boegsted, Martin
AU - Johnsen, Hans E
AU - Seymour, John F
AU - Connors, Joseph M
AU - Brown, Peter D N
AU - Villa, Diego
N1 - © 2016 John Wiley & Sons Ltd.
PY - 2016/12
Y1 - 2016/12
N2 - 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.
AB - 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.
KW - Adolescent
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Central Nervous System Neoplasms
KW - Databases, Factual
KW - Disease-Free Survival
KW - Female
KW - Humans
KW - Lymphoma, Large B-Cell, Diffuse
KW - Middle Aged
KW - Ovarian Neoplasms
KW - Prognosis
KW - Retrospective Studies
KW - Rituximab
KW - Survival Rate
KW - Uterine Neoplasms
KW - Young Adult
KW - Journal Article
KW - Multicenter Study
U2 - 10.1111/bjh.14325
DO - 10.1111/bjh.14325
M3 - Journal article
C2 - 27681999
VL - 175
SP - 876
EP - 883
JO - British Journal of Haematology
JF - British Journal of Haematology
SN - 0007-1048
IS - 5
ER -
ID: 180972146