Impact of bone marrow involvement on outcome in relapsed and refractory transplant eligible diffuse large B-cell lymphoma and transformed indolent lymphoma.
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2020
2020
Historique:
received:
14
03
2020
accepted:
22
06
2020
entrez:
9
7
2020
pubmed:
9
7
2020
medline:
18
9
2020
Statut:
epublish
Résumé
In front-line treatment of diffuse large B-cell lymphoma (DLBCL), prior studies suggest that concordant but not discordant involvement of the bone marrow (BM) portends a poor prognosis. The prognostic impact of bone marrow infiltration (BMI) in recurrent or refractory DLBCL (r/rDLBCL) and transformed indolent lymphoma (r/rTRIL) patients is less clear. Thus, we examined the prognostic significance of the infiltration of bone marrow (BMI) by concordant, large B-cells (conBMI) and discordant, small B-cells (disBMI) in this patient group. We performed a single center retrospective analysis of the prognostic impact of BMI diagnosed before start of second-line treatment as well as multiple clinicopathologic variables in 82 patients with r/rDLBCL or r/rTRIL intended to treat with autologous SCT. Twenty-five of 82 patients (30.5%) had BMI. Out of these, 19 (76%) had conBMI and 6 (24%) had disBMI. In patients with conBMI but not disBMI, uni- and multivariate analysis revealed inferior progression free survival (PFS) and overall survival (OS) compared to patients without BMI (median PFS, 9.2 vs 17.45 months, log rank: p = 0.049; Hazard Ratio, 2.34 (Confidence Interval, 1.24-4.44), p = 0.009; median OS 14.72 vs 28.91 months, log rank: p = 0.017; Hazard Ratio, 2.76 (Confidence Interval, 1.43-5.31), p = 0.002). ConBMI was strongly associated with nonGCB subtype as classified by the Hans algorithm (82.4% vs 17.6%, p = 0.01). ConBMI comprised an independent predictor of poor prognosis in primary and secondary r/rDLBCL. Incorporating conBMI in the pretherapeutic risk assessment for r/rDLBCL and r/rTRIL patients may be useful for prognostication, for stratification in clinical trials, and to assess new therapies for this high-risk patient subset that might not benefit from SCT in second-line treatment.
Identifiants
pubmed: 32639975
doi: 10.1371/journal.pone.0235786
pii: PONE-D-20-07437
pmc: PMC7343149
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0235786Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
J Clin Oncol. 1996 Jul;14(7):2131-8
pubmed: 8683246
J Clin Oncol. 2014 Nov 1;32(31):3490-6
pubmed: 25267740
Ann Oncol. 2011 Jul;22(7):1601-1607
pubmed: 21199885
Bone Marrow Transplant. 2014 Mar;49(3):410-5
pubmed: 24362366
J Clin Oncol. 2010 Sep 20;28(27):4184-90
pubmed: 20660832
N Engl J Med. 1995 Dec 7;333(23):1540-5
pubmed: 7477169
Am J Hematol. 2013 Oct;88(10):890-4
pubmed: 23813874
Blood. 2011 May 12;117(19):5019-32
pubmed: 21300984
J Clin Oncol. 2014 Apr 10;32(11):1112-8
pubmed: 24493716
Nat Med. 2018 May;24(5):679-690
pubmed: 29713087
Blood. 2017 Oct 19;130(16):1800-1808
pubmed: 28774879
Blood. 1998 Nov 15;92(10):3562-8
pubmed: 9808548
N Engl J Med. 2018 Apr 12;378(15):1396-1407
pubmed: 29641966
Mod Pathol. 2011 Sep;24(9):1248-53
pubmed: 21552211
Leukemia. 2018 Feb;32(2):353-363
pubmed: 28745330
Br J Haematol. 2013 Mar;160(5):608-17
pubmed: 23278720
Br J Haematol. 2015 Mar;168(6):824-34
pubmed: 25546611
J Clin Oncol. 2014 Sep 20;32(27):3059-68
pubmed: 25113753
Blood. 2007 Aug 15;110(4):1278-82
pubmed: 17475910
Bone Marrow Transplant. 2016 Jan;51(1):51-7
pubmed: 26367239
Lab Invest. 2003 Jan;83(1):107-14
pubmed: 12533691
Biol Blood Marrow Transplant. 2014 Nov;20(11):1729-36
pubmed: 25008330
Cancer Chemother Rep. 1966 Mar;50(3):163-70
pubmed: 5910392
Cancer. 2012 Sep 1;118(17):4173-83
pubmed: 22213394
Cancer. 2008 Nov 1;113(9):2496-503
pubmed: 18833583
J Clin Oncol. 1998 Oct;16(10):3264-9
pubmed: 9779700
J Clin Oncol. 2011 Apr 10;29(11):1452-7
pubmed: 21383296
Br J Haematol. 2011 Oct;155(1):53-64
pubmed: 21749361
Blood. 2003 Sep 15;102(6):1989-96
pubmed: 12676776
Lancet Oncol. 2014 Jun;15(7):757-66
pubmed: 24827808
Lancet Oncol. 2008 May;9(5):435-44
pubmed: 18400558
Bone Marrow Transplant. 1997 Sep;20(6):451-8
pubmed: 9313877
Blood. 2004 Jan 1;103(1):275-82
pubmed: 14504078
N Engl J Med. 1993 Sep 30;329(14):987-94
pubmed: 8141877
Am J Clin Pathol. 2000 Apr;113(4):512-8
pubmed: 10761452
J Clin Pathol. 2015 Sep;68(9):733-8
pubmed: 25998512
Ann Oncol. 2003 Jan;14(1):140-51
pubmed: 12488306