1. Primary cardiac lymphoma: the management and outcome of a single-centre cohort of 22 patients.
- Author
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Wei, Xiao-Juan, Yuan, Hui, Khong, Pek-Lan, Zhang, Fen, Liao, Peng-Jun, Jiang, Xin-Miao, Huang, Ling, Guo, Han-Guo, Chen, Fei-Li, Liu, Si-Chu, Huang, Yan-Ying, Wang, Shu-Xia, and Li, Wen-Yu
- Subjects
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LYMPHOMA treatment , *HEART tumors , *BIOPSY , *CONFIDENCE intervals , *CANCER chemotherapy , *B cell lymphoma , *TREATMENT effectiveness , *DESCRIPTIVE statistics , *LYMPHOMAS , *ODDS ratio , *DATA analysis software , *LONGITUDINAL method - Abstract
The incidence of primary cardiac lymphoma (PCL) is increasing, but the optimal management approach remains unclear. We assessed the clinical characteristics of a single-centre cohort with the goal of determining the optimal management approach. The treatment outcomes and prognostic factors are reported. All PCL patients were diagnosed via biopsy guided by whole-body imaging (positron emission tomography/computed tomography [PET/CT] and/or contrast-enhanced CT]. Curative therapy involved either surgery or prephase steroids followed by definitive immunochemotherapy, depending on the histological type. The primary outcomes were overall survival (OS) and progression-free survival (PFS); the secondary outcome was the treatment response. Twenty-two PCL patients (14 males, 8 females; age: 59.5 ± 14.7 years [mean ± S.D.]) were histologically confirmed to have diffuse large B-cell lymphoma (DLBCL; n = 17 [77.3%]), fibrin-associated DLBCL (FA-DLBCL) (n = 4 [18.2%]) and Burkitt lymphoma (n = 1 [4.5%]). Seven patients underwent cardiotomy (three for biopsy, four with curative intent). The median and longest follow-up periods were 16.3 and 180.0 months, respectively. The 16 patients who received curative therapy (complete response [CR], n = 15 [93.8%]; partial response [PR], n = 1 [6.2%]) showed better survival than those who did not (5-year OS: 83.0 ± 11.3% vs. 0%; hazard ratio [HR]: 0.025[95% confidence interval, CI: 0.003–0.187], p < 0.001); 5-year PFS: 78.7 ± 11.0% vs. 0%, HR= 0.010[0.001–0.093], p < 0.001). The left ventricular ejection fractions (LVEF) before and after definitive treatment was 63.6 ± 2.4% and 64.6 ± 4.5%, respectively (p = 0.275, power = 0.318). Extrapericardial lesions were associated with poorer survival (5-year OS: 40.0 ± 29.7% vs. 100%, p = 0.027; 5-year PFS:40.0 ± 21.9% vs. 100%, p = 0.010). Whole-body imaging is essential for diagnosis and prognosis. Curative therapy provided reasonable outcomes and survival; extrapericardial lesions were associated with a poorer treatment response. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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