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Early-stage diffuse large B cell lymphoma of the head and neck: clinico-biological characterization and 18 year follow-up of 488 patients (IELSG 23 study)

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Abstract

It is known that extranodal head and neck diffuse large B cell lymphomas (eHN-DLBCL) can affect various anatomical structures what is not well-known, however, is whether they differ in terms of clinical presentation and outcome. Clinical data of the multi-institutional series, the largest of its kind as yet, has been analysed with the aim of answering these open questions and providing long-term follow-up information. Data from 488 patients affected by stage I/II eHN-DLBCL was collected: 300 of the Waldeyer’s Ring (WR), 38 of the parotid and salivary glands (PSG), 48 of the thyroid gland (TG), 53 of the nasal cavity and paranasal sinuses (NPS), 24 of the palate and oral cavity (POC) and 25 with more than one involved site. Different eHN-DLBCL arising have distinct characteristics at presentation. The intermediate high risk-modified IPI was 67 % in TG, 44 % in WR, 38 % in PSG and POC and 20 % in MS. The worst 5-year survival rate had TG-DLBCL (61 %) due to the 61 % of patients with a mIPI >1. The addition of radiotherapy (cRT) to remitters did not translate into a survival advantage (5-year disease-free survival of 67 % in the cRT group vs. 70 % in the other). Three of four central nervous system recurrences occurred in NPS-DLBCL. Survival of HN-DLBCL was inferior to nodal DLBCL. This study showed that eHN-DLBCL remitters have an inferior survival when compared to nodal DLBCL, and that the addition of cRT does not provide a survival advantage. Since the standard of care nowadays is chemo-immunotherapy, survival of these patients might have been improved.

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Acknowledgments

The authors thank Andrés J.M. Ferreri, Annarita Conconi, Monica Bellei and Armando López-Guillermo for their support. This work was supported by the Autonomous Province of Bolzano, the local health authority and Alto Adige Bolzano-AIL “Mirco Federici” Onlus.

Conflicts of interest

The authors have declared no conflicts of interest.

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Authors and Affiliations

  1. Division of Hematology, Azienda Ospedaliera S. Maurizio, Bolzano/Bozen, Italy

    M. Mian, D. Grazio, M. Svaldi & S. Cortelazzo

  2. Lymphoma & Genomics Research Programme, IOR—Institute of Oncology Research, Bellinzona, Switzerland

    M. Mian

  3. Department of Hematology & Oncology, Medical University of Innsbruck, Innsbruck, Austria

    M. Mian & M. Fiegl

  4. Laboratory of Biochemistry and Molecular Biology, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy

    D. Capello

  5. Unit of Lymphoid Malignancies, Department of Onco-Hematology, San Raffaele Scientific Institute, Milan, Italy

    M. B. Ventre

  6. Division of Hematology, Ospedali Riuniti, Bergamo, Italy

    A. Rossi, E. Oldani & A. Rambaldi

  7. Department of Radiation Oncology, University of Toronto, Princess Margaret Hospital, Toronto, Canada

    R. Tsang & M. K. Gospodarowicz

  8. Department of Oncology and Hematology, University of Modena and Reggio Emilia, Modena, Italy

    M. Federico, S. Luminari & L. Marcheselli

  9. Chair of Hematology, University of Milan-Bicocca, Milan, Italy

    E. M. Pogliani & F. Rossini

  10. Hospital del Salvador, Universidad de Chile, Santiago, Chile

    M. E. Cabrera

  11. Chair of Hematology, University of Rome, Rome, Italy

    M. Martelli

  12. Servicio de Hematologia, Hospital Clinic Universitar I, Barcelona, Spain

    G. Gutierrez-Garcia

  13. UOC Radioterapia, UOS Radioterapia Oncoematologica, Ospedale dell’Angelo Mestre, Venice, Italy

    M. Busetto

  14. Department of Hematology, Ospedale San Bortolo, Vicenza, Italy

    C. Visco

  15. Division of Hematology, Department of Clinical and Experimental Medicine & BRMA, Amedeo Avogadro University of Eastern Piedmont, Novara, Italy

    D. Rossi & G. Gaidano

  16. IOSI, Bellinzona, Switzerland

    F. Cavalli & E. Zucca

  17. Department of Hematology, Hospital of Bolzano, Via Lorenz Böhler 5, 39100, Bolzano, Italy

    M. Mian

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  1. M. Mian
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on behalf of the International Extranodal Lymphoma Study Group (IELSG)

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Correspondence to M. Mian.

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Mian, M., Capello, D., Ventre, M.B. et al. Early-stage diffuse large B cell lymphoma of the head and neck: clinico-biological characterization and 18 year follow-up of 488 patients (IELSG 23 study). Ann Hematol 93, 221–231 (2014). https://doi.org/10.1007/s00277-013-1856-4

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