Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
J Hematol Oncol. 2012 Aug 13;5:49. doi: 10.1186/1756-8722-5-49.
The objective of this study was to identify prognostic factors for survival in patients with primary diffuse large B-cell lymphoma (DLBCL) of the adrenal gland.
Thirty one patients diagnosed with primary adrenal DLBCL from 14 Korean institutions and treated with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone) were analyzed.
Complete remission (CR) and overall response rate after R-CHOP chemotherapy were 54.8% and 87.0%. The 2-year estimates of overall survival (OS) and progression-free survival (PFS) were 68.3% and 51.1%. In patients achieving CR, significant prolongations of OS (P = 0.029) and PFS (P = 0.005) were observed. Ann Arbor stage had no influence on OS. There was no significant difference in OS between patients with unilateral involvement of adrenal gland and those with bilateral involvement. When staging was modified to include bilateral adrenal involvement as one extranodal site, early stage (I or II) significantly correlated with longer OS (P = 0.021) and PFS (P <0.001).
Contrary to prior reports, our data suggests that outcomes of primary adrenal DLBCL are encouraging using a regimen of R-CHOP, and that achieving CR after R-CHOP is predictive of survival. Likewise, our modified staging system may have prognostic value.
本研究旨在确定原发性肾上腺弥漫性大 B 细胞淋巴瘤（DLBCL）患者的生存预后因素。
分析了来自 14 家韩国机构的 31 例经诊断患有原发性肾上腺 DLBCL 且接受 R-CHOP（利妥昔单抗、环磷酰胺、多柔比星、长春新碱和泼尼松）治疗的患者。
R-CHOP 化疗后完全缓解（CR）和总缓解率分别为 54.8%和 87.0%。2 年总生存率（OS）和无进展生存率（PFS）估计值分别为 68.3%和 51.1%。在达到 CR 的患者中，OS（P=0.029）和 PFS（P=0.005）显著延长。Ann Arbor 分期对 OS 没有影响。单侧肾上腺受累和双侧肾上腺受累患者的 OS 无显著差异。当分期修改为包括双侧肾上腺受累作为一个结外部位时，早期（I 或 II 期）与更长的 OS（P=0.021）和 PFS（P<0.001）显著相关。
与既往报告相反，我们的数据表明，原发性肾上腺 DLBCL 使用 R-CHOP 方案的治疗效果令人鼓舞，并且 R-CHOP 后达到 CR 是生存的预测因素。同样，我们的改良分期系统可能具有预后价值。
