CD5-positive diffuse large B-cell lymphoma: a retrospective study in 337 patients treated by chemotherapy with or without rituximab

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BlankCD5-positive diffuse large B-cell lymphoma: a retrospective study in 337

patients treated by chemotherapy with or without rituximab

1.. K. Miyazaki1,

2.. M. Yamaguchi1,

3.. R. Suzuki2,

4.. Y. Kobayashi3,

5.. A. M. Maeshima4,

6.. N. Niitsu5,

7.. D. Ennishi6,

8.. J-i. Tamaru7,

9.. K. Ishizawa8,

10.. M. Kashimura9,

11.. Y. Kagami10,

12.. K. Sunami11,

13.. H. Yamane12,

14.. M. Nishikori13,

15.. H. Kosugi14,

16.. T. Yujiri15,

17.. R. Hyo2,

18.. N. Katayama1,

19.. T. Kinoshita16 and

20.. S. Nakamura17

+ Author Affiliations

1.. 1Department of Hematology and Oncology, Mie University Graduate School of

Medicine, Tsu

2.. 2Department of HSCT Data Management and Biostatistics, Nagoya University

Graduate School of Medicine, Nagoya

3.. 3Hematology and Stem Cell Transplantation Division

4.. 4Clinical Laboratory Division, National Cancer Center Hospital, Tokyo

5.. 5Department of Hematology, International Medical Center, Saitama Medical

University, Hidaka

6.. 6Department of Medical Oncology, Cancer Institute Hospital, Tokyo

7.. 7Department of Pathology, Saitama Medical Center, Saitama Medical

University, Kawagoe

8.. 8Department of Hematology and Rheumatology, Tohoku University Hospital,

Sendai

9.. 9Department of Hematology, Matsudo City Hospital, Matsudo

10.. 10Department of Hematology and Cell Therapy, Aichi Cancer Center

Hospital, Nagoya

11.. 11Department of Hematology, National Hospital Organization Okayama

Medical Center, Okayama

12.. 12Division of Clinical Oncology, Sumitomo-Besshi Hospital Cancer Center,

Niihama

13.. 13Department of Hematology and Oncology, Kyoto University, Kyoto

14.. 14Department of Hematology, Ogaki Municipal Hospital, Ogaki

15.. 15Department of Hematology, Yamaguchi University, Yamaguchi

16.. 16Departments of Hematology and Oncology

17.. 17Pathology, Nagoya University Graduate School of Medicine, Nagoya, Japan

1.. Correspondence to: Dr M. Yamaguchi, Department of Hematology and Oncology,

Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507,

Japan. Tel: +81-59-231-5418; Fax: +81-59-231-5419; E-mail:

waniwani@...

a.. Received April 14, 2010.

b.. Revision received July 16, 2010.

c.. Accepted September 22, 2010.

Abstract

Background: CD5-positive (CD5+) diffuse large B-cell lymphoma (DLBCL) shows poor

prognosis and frequent central nervous system (CNS) relapses under

anthracycline-containing chemotherapy. The aim of this study was to determine

the prognosis and CNS relapse incidence of CD5+ DLBCL in the rituximab era.

Patients and methods: We analyzed 337 patients with CD5+ DLBCL who received

chemotherapy with (R-chemotherapy group; n = 184) or without (chemotherapy

group; n = 153) rituximab.

Results: No significant difference was found in clinical background comparisons

between the two groups. In the R-chemotherapy group, 60% of the patients were

older than 65 years at diagnosis. Both the complete response rate and overall

survival (OS) were significantly better in the R-chemotherapy group (P = 0.0003

and P = 0.002, respectively). Multivariate analysis confirmed that chemotherapy

without rituximab was associated with unfavorable OS. However, the probability

of CNS relapse did not differ between the two groups (P = 0.89). The CNS relapse

was strongly associated with short OS (P < 0.0001). In the R-chemotherapy group,

83% of patients who experienced CNS relapse had parenchymal disease.

Conclusions: Our results indicate that rituximab improves the OS of patients

with CD5+ DLBCL but does not decrease the CNS relapse rate. More effective

treatments with CNS prophylaxis are needed for CD5+ DLBCL patients.