Matched-pair analysis comparing the outcomes of primary breast and nodal diffuse large B-cell lymphoma in patients treated with rituximab plus chemotherapy

Ho Young Yhim, Jin Seok Kim, Hye Jin Kang, Seok Jin Kim, Won Seog Kim, Chul Won Choi, Hyeon Seok Eom, Jeong A. Kim, Jae Hoon Lee, Jong Ho Won, Hyeok Shim, Jooryung Huh, Dae Ho Lee, Cheolwon Suh, Jae Yong Kwak

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Abstract

Primary breast diffuse large B-cell lymphoma (DLBCL) is an extremely rare presentation of non-Hodgkin's lymphoma that has been associated with poorer clinical outcomes compared with nodal DLBCL in the pre-rituximab era. The aim of this study was to investigate the impact of rituximab on clinical outcomes in patients with primary breast DLBCL. Data from 25 female patients with primary breast DLBCL receiving rituximab plus chemotherapy were matched to 75 female patients (1:3) with nodal DLBCL by following five established prognostic factors (age, Ann Arbor stage, Eastern Cooperative Oncology Group performance status, serum lactate dehydrogenase level and B symptoms). Overall survival (OS) was similar between primary breast and nodal DLBCL groups (3-year OS rate, 82.2% vs. 90.7%, respectively; p = 0.345). In the analysis of immunohistochemically defined prognostic subgroups, 19 of 20 available cases in the primary breast DLBCL group displayed a non-germinal center (GC) phenotype. Compared with patterns of recurrence, extranodal progression in the breast or central nervous system (CNS) was significantly higher in the primary breast DLBCL group than in the nodal DLBCL group (p < 0.001). Additionally, the stage-modified International Prognostic Index was the only independent prognostic factor for OS in this population. This suggests that clinical outcomes of primary breast DLBCL might no longer be inferior to those of nodal DLBCL in the rituximab era, which might be associated with the intrinsic biologic characteristics of the non-GC phenotype. However, despite including rituximab, extranodal progression in the breast or CNS was problematic. This study was registered at as no. NCT01266668.

Original languageEnglish
Pages (from-to)235-243
Number of pages9
JournalInternational Journal of Cancer
Volume131
Issue number1
DOIs
Publication statusPublished - 2012 Jul 1

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Matched-Pair Analysis
Lymphoma, Large B-Cell, Diffuse
Breast
Drug Therapy
Rituximab
Central Nervous System
Phenotype
Survival
Non-Hodgkin's Lymphoma
Survival Rate

Keywords

  • breast
  • central nervous system
  • diffuse large B-cell lymphoma
  • rituximab

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Matched-pair analysis comparing the outcomes of primary breast and nodal diffuse large B-cell lymphoma in patients treated with rituximab plus chemotherapy. / Yhim, Ho Young; Kim, Jin Seok; Kang, Hye Jin; Kim, Seok Jin; Kim, Won Seog; Choi, Chul Won; Eom, Hyeon Seok; Kim, Jeong A.; Lee, Jae Hoon; Won, Jong Ho; Shim, Hyeok; Huh, Jooryung; Lee, Dae Ho; Suh, Cheolwon; Kwak, Jae Yong.

In: International Journal of Cancer, Vol. 131, No. 1, 01.07.2012, p. 235-243.

Research output: Contribution to journalArticle

Yhim, HY, Kim, JS, Kang, HJ, Kim, SJ, Kim, WS, Choi, CW, Eom, HS, Kim, JA, Lee, JH, Won, JH, Shim, H, Huh, J, Lee, DH, Suh, C & Kwak, JY 2012, 'Matched-pair analysis comparing the outcomes of primary breast and nodal diffuse large B-cell lymphoma in patients treated with rituximab plus chemotherapy', International Journal of Cancer, vol. 131, no. 1, pp. 235-243. https://doi.org/10.1002/ijc.26352
Yhim, Ho Young ; Kim, Jin Seok ; Kang, Hye Jin ; Kim, Seok Jin ; Kim, Won Seog ; Choi, Chul Won ; Eom, Hyeon Seok ; Kim, Jeong A. ; Lee, Jae Hoon ; Won, Jong Ho ; Shim, Hyeok ; Huh, Jooryung ; Lee, Dae Ho ; Suh, Cheolwon ; Kwak, Jae Yong. / Matched-pair analysis comparing the outcomes of primary breast and nodal diffuse large B-cell lymphoma in patients treated with rituximab plus chemotherapy. In: International Journal of Cancer. 2012 ; Vol. 131, No. 1. pp. 235-243.
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abstract = "Primary breast diffuse large B-cell lymphoma (DLBCL) is an extremely rare presentation of non-Hodgkin's lymphoma that has been associated with poorer clinical outcomes compared with nodal DLBCL in the pre-rituximab era. The aim of this study was to investigate the impact of rituximab on clinical outcomes in patients with primary breast DLBCL. Data from 25 female patients with primary breast DLBCL receiving rituximab plus chemotherapy were matched to 75 female patients (1:3) with nodal DLBCL by following five established prognostic factors (age, Ann Arbor stage, Eastern Cooperative Oncology Group performance status, serum lactate dehydrogenase level and B symptoms). Overall survival (OS) was similar between primary breast and nodal DLBCL groups (3-year OS rate, 82.2{\%} vs. 90.7{\%}, respectively; p = 0.345). In the analysis of immunohistochemically defined prognostic subgroups, 19 of 20 available cases in the primary breast DLBCL group displayed a non-germinal center (GC) phenotype. Compared with patterns of recurrence, extranodal progression in the breast or central nervous system (CNS) was significantly higher in the primary breast DLBCL group than in the nodal DLBCL group (p < 0.001). Additionally, the stage-modified International Prognostic Index was the only independent prognostic factor for OS in this population. This suggests that clinical outcomes of primary breast DLBCL might no longer be inferior to those of nodal DLBCL in the rituximab era, which might be associated with the intrinsic biologic characteristics of the non-GC phenotype. However, despite including rituximab, extranodal progression in the breast or CNS was problematic. This study was registered at as no. NCT01266668.",
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