Clinical outcomes and prognostic factors in patients with breast diffuse large B cell lymphoma; Consortium for Improving Survival of Lymphoma (CISL) study

Ho Young Yhim, Hye J. Kang, Yoon H. Choi, Seok J. Kim, Won S. Kim, Yee S. Chae, Jin S. Kim, Chul W. Choi, Sung Y. Oh, Hyeon S. Eom, Jeong A. Kim, Jae H. Lee, Jong Ho Won, Hyeok Shim, Je Jung Lee, Hwa J. Sung, Hyo J. Kim, Dae H. Lee, Cheolwon Suh, Jae Yong Kwak

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Abstract

Background: The breast is a rare extranodal site of non-Hodgkin lymphoma, and primary breast lymphoma (PBL) has been arbitrarily defined as disease localized to one or both breasts with or without regional lymph nodes involvement. The aim of this study was to evaluate the clinical outcomes in patients with diffuse large B cell lymphoma (DLBCL) and breast involvement, and to find the criteria of PBL reflecting the outcome and prognosis.Methods: We retrospectively analyzed data from 68 patients, newly diagnosed with DLBCL and breast involvement at 16 Korean institutions between January 1994 and June 2009.Results: Median age at diagnosis was 48 years (range, 20-83 years). Forty-three (63.2%) patients were PBL according to previous arbitrary criteria, sixteen (23.5%) patients were high-intermediate to high risk of international prognostic index. The patients with one extranodal disease in the breast (OED) with or without nodal disease were 49 (72.1%), and those with multiple extranodal disease (MED) were 19 (27.9%). During median follow-up of 41.5 months (range, 2.4-186.0 months), estimated 5-year progression-free survival (PFS) was 53.7 ± 7.6%, and overall survival (OS) was 60.3 ± 7.2%. The 5-year PFS and OS was significantly higher for patients with the OED group than those with the MED group (5-year PFS, 64.9 ± 8.9% vs. 27.5 ± 11.4%, p = 0.001; 5-year OS, 74.3 ± 7.6% vs. 24.5 ± 13.0%, p < 0.001). In multivariate analysis, MED (hazard ratio [HR], 3.61; 95% confidence interval [CI], 1.07-12.2) and fewer than four cycles of systemic chemotherapy with or without local treatments (HR, 4.47; 95% CI, 1.54-12.96) were independent prognostic factors for worse OS. Twenty-five (36.8%) patients experienced progression, and the cumulative incidence of progression in multiple extranodal sites or other than breasts and central nervous system was significantly different between the OED group and the MED group (5-year cumulative incidence, 9.7 ± 5.4% vs. 49.0 ± 15.1%, p = 0.001).Conclusions: Our results show that the patients included in OED group, reflecting different treatment outcome, prognosis and pattern of progression, should be considered as PBL in the future trial. Further studies are warranted to validate our suggested criteria.

Original languageEnglish
Article number321
JournalBMC cancer
Volume10
DOIs
Publication statusPublished - 2010 Jun 22

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Lymphoma, Large B-Cell, Diffuse
Lymphoma
Breast
Survival
Breast Diseases
Disease-Free Survival
Confidence Intervals
Incidence
Non-Hodgkin's Lymphoma
Multivariate Analysis
Central Nervous System
Lymph Nodes
Drug Therapy

All Science Journal Classification (ASJC) codes

  • Genetics
  • Oncology
  • Cancer Research

Cite this

Yhim, Ho Young ; Kang, Hye J. ; Choi, Yoon H. ; Kim, Seok J. ; Kim, Won S. ; Chae, Yee S. ; Kim, Jin S. ; Choi, Chul W. ; Oh, Sung Y. ; Eom, Hyeon S. ; Kim, Jeong A. ; Lee, Jae H. ; Won, Jong Ho ; Shim, Hyeok ; Lee, Je Jung ; Sung, Hwa J. ; Kim, Hyo J. ; Lee, Dae H. ; Suh, Cheolwon ; Kwak, Jae Yong. / Clinical outcomes and prognostic factors in patients with breast diffuse large B cell lymphoma; Consortium for Improving Survival of Lymphoma (CISL) study. In: BMC cancer. 2010 ; Vol. 10.
@article{a31f27f3898844b9afe25c71d9839373,
title = "Clinical outcomes and prognostic factors in patients with breast diffuse large B cell lymphoma; Consortium for Improving Survival of Lymphoma (CISL) study",
abstract = "Background: The breast is a rare extranodal site of non-Hodgkin lymphoma, and primary breast lymphoma (PBL) has been arbitrarily defined as disease localized to one or both breasts with or without regional lymph nodes involvement. The aim of this study was to evaluate the clinical outcomes in patients with diffuse large B cell lymphoma (DLBCL) and breast involvement, and to find the criteria of PBL reflecting the outcome and prognosis.Methods: We retrospectively analyzed data from 68 patients, newly diagnosed with DLBCL and breast involvement at 16 Korean institutions between January 1994 and June 2009.Results: Median age at diagnosis was 48 years (range, 20-83 years). Forty-three (63.2{\%}) patients were PBL according to previous arbitrary criteria, sixteen (23.5{\%}) patients were high-intermediate to high risk of international prognostic index. The patients with one extranodal disease in the breast (OED) with or without nodal disease were 49 (72.1{\%}), and those with multiple extranodal disease (MED) were 19 (27.9{\%}). During median follow-up of 41.5 months (range, 2.4-186.0 months), estimated 5-year progression-free survival (PFS) was 53.7 ± 7.6{\%}, and overall survival (OS) was 60.3 ± 7.2{\%}. The 5-year PFS and OS was significantly higher for patients with the OED group than those with the MED group (5-year PFS, 64.9 ± 8.9{\%} vs. 27.5 ± 11.4{\%}, p = 0.001; 5-year OS, 74.3 ± 7.6{\%} vs. 24.5 ± 13.0{\%}, p < 0.001). In multivariate analysis, MED (hazard ratio [HR], 3.61; 95{\%} confidence interval [CI], 1.07-12.2) and fewer than four cycles of systemic chemotherapy with or without local treatments (HR, 4.47; 95{\%} CI, 1.54-12.96) were independent prognostic factors for worse OS. Twenty-five (36.8{\%}) patients experienced progression, and the cumulative incidence of progression in multiple extranodal sites or other than breasts and central nervous system was significantly different between the OED group and the MED group (5-year cumulative incidence, 9.7 ± 5.4{\%} vs. 49.0 ± 15.1{\%}, p = 0.001).Conclusions: Our results show that the patients included in OED group, reflecting different treatment outcome, prognosis and pattern of progression, should be considered as PBL in the future trial. Further studies are warranted to validate our suggested criteria.",
author = "Yhim, {Ho Young} and Kang, {Hye J.} and Choi, {Yoon H.} and Kim, {Seok J.} and Kim, {Won S.} and Chae, {Yee S.} and Kim, {Jin S.} and Choi, {Chul W.} and Oh, {Sung Y.} and Eom, {Hyeon S.} and Kim, {Jeong A.} and Lee, {Jae H.} and Won, {Jong Ho} and Hyeok Shim and Lee, {Je Jung} and Sung, {Hwa J.} and Kim, {Hyo J.} and Lee, {Dae H.} and Cheolwon Suh and Kwak, {Jae Yong}",
year = "2010",
month = "6",
day = "22",
doi = "10.1186/1471-2407-10-321",
language = "English",
volume = "10",
journal = "BMC Cancer",
issn = "1471-2407",
publisher = "BioMed Central",

}

Yhim, HY, Kang, HJ, Choi, YH, Kim, SJ, Kim, WS, Chae, YS, Kim, JS, Choi, CW, Oh, SY, Eom, HS, Kim, JA, Lee, JH, Won, JH, Shim, H, Lee, JJ, Sung, HJ, Kim, HJ, Lee, DH, Suh, C & Kwak, JY 2010, 'Clinical outcomes and prognostic factors in patients with breast diffuse large B cell lymphoma; Consortium for Improving Survival of Lymphoma (CISL) study', BMC cancer, vol. 10, 321. https://doi.org/10.1186/1471-2407-10-321

Clinical outcomes and prognostic factors in patients with breast diffuse large B cell lymphoma; Consortium for Improving Survival of Lymphoma (CISL) study. / Yhim, Ho Young; Kang, Hye J.; Choi, Yoon H.; Kim, Seok J.; Kim, Won S.; Chae, Yee S.; Kim, Jin S.; Choi, Chul W.; Oh, Sung Y.; Eom, Hyeon S.; Kim, Jeong A.; Lee, Jae H.; Won, Jong Ho; Shim, Hyeok; Lee, Je Jung; Sung, Hwa J.; Kim, Hyo J.; Lee, Dae H.; Suh, Cheolwon; Kwak, Jae Yong.

In: BMC cancer, Vol. 10, 321, 22.06.2010.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Clinical outcomes and prognostic factors in patients with breast diffuse large B cell lymphoma; Consortium for Improving Survival of Lymphoma (CISL) study

AU - Yhim, Ho Young

AU - Kang, Hye J.

AU - Choi, Yoon H.

AU - Kim, Seok J.

AU - Kim, Won S.

AU - Chae, Yee S.

AU - Kim, Jin S.

AU - Choi, Chul W.

AU - Oh, Sung Y.

AU - Eom, Hyeon S.

AU - Kim, Jeong A.

AU - Lee, Jae H.

AU - Won, Jong Ho

AU - Shim, Hyeok

AU - Lee, Je Jung

AU - Sung, Hwa J.

AU - Kim, Hyo J.

AU - Lee, Dae H.

AU - Suh, Cheolwon

AU - Kwak, Jae Yong

PY - 2010/6/22

Y1 - 2010/6/22

N2 - Background: The breast is a rare extranodal site of non-Hodgkin lymphoma, and primary breast lymphoma (PBL) has been arbitrarily defined as disease localized to one or both breasts with or without regional lymph nodes involvement. The aim of this study was to evaluate the clinical outcomes in patients with diffuse large B cell lymphoma (DLBCL) and breast involvement, and to find the criteria of PBL reflecting the outcome and prognosis.Methods: We retrospectively analyzed data from 68 patients, newly diagnosed with DLBCL and breast involvement at 16 Korean institutions between January 1994 and June 2009.Results: Median age at diagnosis was 48 years (range, 20-83 years). Forty-three (63.2%) patients were PBL according to previous arbitrary criteria, sixteen (23.5%) patients were high-intermediate to high risk of international prognostic index. The patients with one extranodal disease in the breast (OED) with or without nodal disease were 49 (72.1%), and those with multiple extranodal disease (MED) were 19 (27.9%). During median follow-up of 41.5 months (range, 2.4-186.0 months), estimated 5-year progression-free survival (PFS) was 53.7 ± 7.6%, and overall survival (OS) was 60.3 ± 7.2%. The 5-year PFS and OS was significantly higher for patients with the OED group than those with the MED group (5-year PFS, 64.9 ± 8.9% vs. 27.5 ± 11.4%, p = 0.001; 5-year OS, 74.3 ± 7.6% vs. 24.5 ± 13.0%, p < 0.001). In multivariate analysis, MED (hazard ratio [HR], 3.61; 95% confidence interval [CI], 1.07-12.2) and fewer than four cycles of systemic chemotherapy with or without local treatments (HR, 4.47; 95% CI, 1.54-12.96) were independent prognostic factors for worse OS. Twenty-five (36.8%) patients experienced progression, and the cumulative incidence of progression in multiple extranodal sites or other than breasts and central nervous system was significantly different between the OED group and the MED group (5-year cumulative incidence, 9.7 ± 5.4% vs. 49.0 ± 15.1%, p = 0.001).Conclusions: Our results show that the patients included in OED group, reflecting different treatment outcome, prognosis and pattern of progression, should be considered as PBL in the future trial. Further studies are warranted to validate our suggested criteria.

AB - Background: The breast is a rare extranodal site of non-Hodgkin lymphoma, and primary breast lymphoma (PBL) has been arbitrarily defined as disease localized to one or both breasts with or without regional lymph nodes involvement. The aim of this study was to evaluate the clinical outcomes in patients with diffuse large B cell lymphoma (DLBCL) and breast involvement, and to find the criteria of PBL reflecting the outcome and prognosis.Methods: We retrospectively analyzed data from 68 patients, newly diagnosed with DLBCL and breast involvement at 16 Korean institutions between January 1994 and June 2009.Results: Median age at diagnosis was 48 years (range, 20-83 years). Forty-three (63.2%) patients were PBL according to previous arbitrary criteria, sixteen (23.5%) patients were high-intermediate to high risk of international prognostic index. The patients with one extranodal disease in the breast (OED) with or without nodal disease were 49 (72.1%), and those with multiple extranodal disease (MED) were 19 (27.9%). During median follow-up of 41.5 months (range, 2.4-186.0 months), estimated 5-year progression-free survival (PFS) was 53.7 ± 7.6%, and overall survival (OS) was 60.3 ± 7.2%. The 5-year PFS and OS was significantly higher for patients with the OED group than those with the MED group (5-year PFS, 64.9 ± 8.9% vs. 27.5 ± 11.4%, p = 0.001; 5-year OS, 74.3 ± 7.6% vs. 24.5 ± 13.0%, p < 0.001). In multivariate analysis, MED (hazard ratio [HR], 3.61; 95% confidence interval [CI], 1.07-12.2) and fewer than four cycles of systemic chemotherapy with or without local treatments (HR, 4.47; 95% CI, 1.54-12.96) were independent prognostic factors for worse OS. Twenty-five (36.8%) patients experienced progression, and the cumulative incidence of progression in multiple extranodal sites or other than breasts and central nervous system was significantly different between the OED group and the MED group (5-year cumulative incidence, 9.7 ± 5.4% vs. 49.0 ± 15.1%, p = 0.001).Conclusions: Our results show that the patients included in OED group, reflecting different treatment outcome, prognosis and pattern of progression, should be considered as PBL in the future trial. Further studies are warranted to validate our suggested criteria.

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