Clinical features and outcome of the patients with sinonasal tract diffuse large B‐cell lymphoma in the pre‐rituximab and rituximab eras. (9th April 2019)

• Record Type: Journal Article
• Authors: Vähämurto, Pauli; Mannisto, Susanna; Pollari, Marjukka; Karjalainen‐Lindsberg, Marja‐Liisa; Mäkitie, Antti A.; Leppä, Sirpa
• Is Part Of: European journal of haematology. Volume 102:Number 6(2019)
• Page Start: 457
• Page End: 464
• Publication Date: 2019-04-09
• Subjects: clinical presentation -- diffuse large B‐cell lymphoma -- sinonasal tract -- survival; Hematology -- Periodicals; Blood -- Diseases -- Periodicals; Blood -- Periodicals; 616.15005
• DOI: 10.1111/ejh.13225
• Languages: English
• ISSNs: 0902-4441

Abstract

Abstract: Purpose: Sinonasal tract diffuse large B‐cell lymphoma (SNT‐DLBCL), a rare extranodal lymphoma, is not well characterized. We performed a population‐based study to determine cell‐of‐origin, clinical presentation and impact of rituximab (R) and central nervous system (CNS) directed chemotherapy on survival. Patients and methods: Patients with SNT‐DLBCL were identified from pathology databases. Clinical information was collected and outcomes between different treatment modalities evaluated. Results: Thirty‐two percent of the patients had germinal centre B‐cell phenotype. Forty‐six patients were treated with curative intent using CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone) or CHOP‐like chemotherapy, 21 (46%) before and 25 (54%) in the R‐era. Additionally, 24 (52%) received CNS‐directed chemotherapy. Addition of R to chemotherapy reduced the risk of progression (RR = 0.368, 95% CI 0.138‐0.976, P = 0.045) and death (RR = 0.245, 95% CI 0.068‐0.883, P = 0.032), and translated into better survival (5‐year PFS, 67% vs 38%, P = 0.037; 5‐year OS, 81% vs 48%, P = 0.020). CNS‐directed chemotherapy reduced the risk of progression (RR = 0.404, 95% CI 0.159‐1.029, P = 0.057) and death (RR = 0.298, 95% CI 0.093‐0.950, P = 0.041), and translated into favorable survival (5‐year PFS, 67% vs 32%, P = 0.050; 5‐year OS 82% vs 43%, P = 0.030). Conclusion: Patients with SNT‐DLBCL benefit from rituximab and CNS‐directed chemotherapy.