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Diffuse large B-cell lymphoma of Waldeyer's ring has distinct clinicopathologic features: a GELA study
- Source :
- Annals of Oncology, vol. 23, no. 12, pp. 3143-3151
- Publication Year :
- 2012
-
Abstract
- Background Diffuse large B-cell lymphomas (DLBCLs) arising in specific extranodal sites have peculiar clinicopathologic features. Patients and methods We analyzed a cohort of 187 primary Waldeyer's ring (WR) DLBCLs retrieved from GELA protocols using anthracyclin-based polychemotherapy. Results Most patients (92%) had stage I–II disease. A germinal center B-cell-like (GCB) immunophenotype was observed in 61%, and BCL2 expression in 55%, of WR DLBCLs. BCL2, BCL6, IRF4 and MYC breakpoints were observed in, respectively, 3 of 42 (7%), 9 of 36 (25%), 2 of 26 (8%) and 4 of 40 (10%) contributive cases. A variable follicular pattern was evidenced in 30 of 68 (44%) large biopsy specimens. The 5-year progression-free survival (PFS) and the overall survival (OS) of 153 WR DLBCL patients with survival information were 69.5% and 77.8%, respectively. The GCB immunophenotype correlated with a better OS (P = 0.0015), while BCL2 expression predicted a worse OS (P = 0.037), an effect overcome by the GCB/non-GCB classification. Compared with matched nodal DLBCLs, WR DLBCLs with no age-adjusted international prognostic index factor disclosed a better 5-year PFS rate (77.5% versus 70.7%; P = 0.03). Conclusions WR DLBCLs display distinct clinicopathologic features compared with conventional DLBCLs, with usual localized-stage disease, common follicular features and a high frequency of GCB immunophenotype contrasting with a low rate of BCL2 rearrangements. In addition, they seem to be associated with a better outcome than their nodal counterpart.
- Subjects :
- Male
medicine.medical_specialty
Gastroenterology
Disease-Free Survival
Proto-Oncogene Proteins c-myc
International Prognostic Index
Immunophenotyping
Internal medicine
hemic and lymphatic diseases
Biopsy
medicine
Humans
Anthracyclines
Stage (cooking)
B-Lymphocytes
medicine.diagnostic_test
business.industry
Germinal center
Pharyngeal Neoplasms
Hematology
Middle Aged
medicine.disease
BCL6
Lymphoma
DNA-Binding Proteins
Oncology
Proto-Oncogene Proteins c-bcl-2
Immunology
Interferon Regulatory Factors
Proto-Oncogene Proteins c-bcl-6
Female
Lymphoma, Large B-Cell, Diffuse
business
Diffuse large B-cell lymphoma
Subjects
Details
- ISSN :
- 15698041
- Volume :
- 23
- Issue :
- 12
- Database :
- OpenAIRE
- Journal :
- Annals of oncology : official journal of the European Society for Medical Oncology
- Accession number :
- edsair.doi.dedup.....a4954aae2ea5b8169afc9a3ff35178ff