Treatment and prognosis of primary pulmonary lymphoma: A long-term follow-up study.
aggressive B-NHL
indolent B-NHL
lymphoproliferative diseases
non-Hodgkin's lymphoma
Journal
European journal of haematology
ISSN: 1600-0609
Titre abrégé: Eur J Haematol
Pays: England
ID NLM: 8703985
Informations de publication
Date de publication:
Jan 2021
Jan 2021
Historique:
received:
23
06
2020
revised:
07
08
2020
accepted:
07
08
2020
pubmed:
12
8
2020
medline:
29
7
2021
entrez:
12
8
2020
Statut:
ppublish
Résumé
Primary pulmonary lymphoma (PPL) is a rare disease with not well-defined optimal treatment. Outcomes and follow-up are variable in published data. To define the outcome and optimal treatment strategies in PPL. We reviewed the medical records of 49 patients with PPL treated in three Italian Hematological Institutions between 2002 and 2018. Thirty-eight (77.5%) cases were indolent PPL, and 11 (22.5%) cases were aggressive PPL. The majority of patients were asymptomatic at diagnosis, early stages (stages IE-IIE), normal serum LDH, no bone marrow involvement, and low or low-intermediate risks of IPI. Local therapy ± immunotherapy or immuno-chemotherapy was possible in 18/49 (37%) patients. Twenty-eight (57%) patients were treated with immuno-chemotherapy after biopsy. Waiting and watching were reported in 3 (6%) patients. Overall, the CR and ORR were 83.7% and 95.9%. With a median follow-up of 62.5 months (range 0.8-199 months), the estimated 5- and 10-year OS rates were 85% and 72.3% for all patients, 89.2% and 80.3% for indolent PPL, and 70.7% and 47.1% for aggressive PPL. Aggressive PPL tended to have a high risk of progression in the first months (P = .056). No advantages were found for indolent PPL who received immuno-chemotherapy or more conservative approaches. Our studies confirm the epidemiological and favorable survival of patients with PPL, suggesting a very conservative approach, particularly in indolent subtypes.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
49-57Informations de copyright
© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Références
Cadranel J, Wislez M, Antoine M. Primary pulmonary lymphoma. Eur Respir J. 2002;20:750-762.
Freeman C, Berg JW, Cutler SJ. Occurrence and prognosis of extranodal lymphomas. Cancer. 1972;29:252-260.
Ferraro P, Trastek VF, Adlakha H, Deschamps C, Allen MS, Pairolero PC. Primary non-Hodgkin's lymphoma of the lung. Ann Thorac Surg. 2000;69:993-997.
Piña-Oviedo S, Weissferdt A, Kalhor N, Moran CA. Primary pulmonary lymphomas. Adv Anat Pathol. 2015;22:355-375.
Nahorecki A, Chabowski M, Straszak E, et al. Primary pulmonary MALT lymphoma - Case report and literature overview. Eur Rev Med Pharmacol Sci. 2016;20:2065-2069.
Borie R, Wislez M, Thabut G, et al. Clinical characteristics and prognostic factors of pulmonary MALT lymphoma. Eur Respir J. 2009;34:1408-1416.
Sirajuddin A, Raparia K, Lewis VA, et al. Primary pulmonary lymphoid lesions: Radiologic and pathologic findings. Radiographics. 2016;36:53-70.
Kligerman SJ, Franks TJ, Galvin JR. Primary extranodal lymphoma of the thorax. Radiol Clin North Am. 2016;54:673-687.
Hare SS, Souza CA, Bain G, et al. The radiological spectrum of pulmonary lymphoproliferative disease. Br J Radiol. 2012;85:848-864.
Graham BB, Mathisen DJ, Mark EJ, Takvorian RW. Primary pulmonary lymphoma. Ann Thorac Surg. 2005;80:1248-1253.
Neri N, Nambo MJ, Avilés A. Diffuse large B-cell lymphoma primary of lung. Hematology. 2011;16:110-112.
Swerdlow SH, Campo E, Harris NL, et al. WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. Revised 4th ed. Lyon, France: IARC Press; 2008.
Swerdlow SH, Campo E, Pileri SA, et al. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood. 2016;127:2375-2390.
Cheson BD, Fisher RI, Barrington SF, et al. Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the lugano classification. J Clin Oncol. 2014;32:3059-3068.
Khalil MO, Morton LM, Devesa SS, et al. Incidence of marginal zone lymphoma in the United States, 2001-2009 with a focus on primary anatomic site. Br J Haematol. 2014;165:67-77.
Zhang XY, Gu DM, Guo JJ, Su QQ, Chen YB. Primary pulmonary lymphoma: a retrospective analysis of 27 cases in a single tertiary hospital. Am J Med Sci. 2019;357:316-322.
Quian J, Luo DL, Zhang JE, et al. Diagnostic and prognostic factors for patients with primary pulmonary non-Hodgkin's lymphoma: a 16-years single center retrospective study. Oncology Letters. 2019;18:2082-2090.
Zhang MC, Zhou M, Son Q, et al. Clinical features and outcomes of pulmonary lymphoma: a single center experience of 180 cases. Lung Cancer. 2019;132:39-44.
Wöhrer S, Kiesewetter B, Fischbach J, et al. Retrospective comparison of the effectiveness of various treatment modalities of extragastric MALT lymphoma: a single-center analysis. Ann Hematol. 2014;93:1287-1295.
Wang L, Ye G, Liu Z, et al. Clinical characteristics, diagnosis, treatment, and prognostic factors of pulmonary mucosa-associated lymphoid tissue-derived lymphoma. Cancer Med. 2019;8:7660-7668.
Conconi A, Martinelli G, Thieblemont C, et al. Clinical activity of rituximab in extranodal marginal zone B-cell lymphoma of MALT type. Blood. 2003;102:2741-2745.
Okamura I, Imai H, Mori K, et al. Rituximab monotherapy as a first-line treatment for pulmonary mucosa-associated lymphoid tissue lymphoma. Int J Hematol. 2015;101:46-51.
Zucca E, Conconi A, Laszlo D, et al. Addition of rituximab to chlorambucil produces superior event-free survival in the treatment of patients with extranodal marginal-zone B-cell lymphoma: 5-years analysis of the IELSG-19 Randomized Study. J Clin Oncol. 2013;31:565-572.
Zucca E, Conconi A, Martinelli G, et al. Final results of the IELSG-19 randomized trial of mucosa-associated lymphoid tissue lymphoma: improved event-free and progression-free survival with rituximab plus chlorambucil versus either chlorambucil or rituximab monotherapy. J Clin Oncol. 2017;35:1905-1912.
Sammassimo S, Pruneri G, Andreola G, et al. A retrospective international study on primary extranodal marginal zone lymphoma of the lung (BALT lymphoma) on behalf of International Extranodal Lymphoma Study Group (IELSG). Hematol Oncol. 2016;34:177-183.
Aviles A, Nambo MJ, Huerta-Guzman J, Silva L, Neri N. Rituximab in the treatment of diffuse large B-cell lymphoma primary of the lung. Hematology. 2013;18:81-84.