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Retrospective analysis of primary gastric diffuse large B cell lymphoma in the rituximab era: a multicenter study of 95 patients in Japan

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Abstract

Primary gastric diffuse large B cell lymphoma (PG-DLBCL) is common subtype of extranodal non-Hodgkin lymphoma. The optimal treatment strategy for PG-DLBCL in the rituximab era still remains unknown. To evaluate clinical outcomes of PG-DLBCL in the rituximab era, we conducted a retrospective, multicenter analysis of 95 patients with PG-DLBCL. In 58 patients with localized disease, 3-year progression-free survival (PFS) and overall survival (OS) were 91% and 91% for patients with six cycles of rituximab plus CHOP (R-CHOP) and 92% and 95% for patients with three to four cycles of R-CHOP plus radiotherapy (Log-rank test, P = 0.595 and P = 0.278, respectively). In 37 patients with advanced disease, 3-year PFS and 3-year OS were 43% and 64% for patients with R-CHOP chemotherapy with or without radiotherapy. On multivariate analysis, advanced stage and elevated serum LDH levels were independent predictors of survival in patients with PG-DLBCL. One patient with localized disease relapsed in lymph node, and eight patients with advanced disease relapsed in lymph node (n = 3), stomach (n = 2), central nervous system (CNS; n = 2), and duodenum (n = 1). Intriguingly, CNS relapse developed within 6 months after initial series of treatment (4.9 and 5.8 months, respectively), and stomach relapse developed in later phase (27.2 and 32.9 months, respectively). Clinical outcomes of PG-DLBCL were extremely favorable for localized-stage patients in the rituximab era, although these might be poor for advanced-stage patients even in the rituximab era. Further prospective analyses are warranted.

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Acknowledgments

We are indebted to Dr. Tatsuya Ito, Department of Hematology, Anjo Kosei Hospital, and Dr. Hisamitsu Suzuki, Department of Hematology, Okazaki Municipal Hospital, for their contribution to the collection of patient data.

Funding

This work was supported in part by a Grant-in-aid for Cancer Research from the Ministry of Education, Culture, Sports, Science and Technology, Japan, and a Grant-in-aid for delineation of molecular biological profile of the refractory lymphoid malignancy and the development of its tumor type-specific management from the Ministry of Health, Labor, and Welfare, Japan.

Conflict of interest disclosure

The authors declare no competing financial interests.

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Authors and Affiliations

  1. Department of Gastroenterology, Nagoya University Graduate School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya, 466-8550, Japan

    Tsutomu Tanaka, Yoshiki Hirooka & Hidemi Goto

  2. Department of Pathology and Clinical Laboratories, Nagoya University Hospital, Nagoya, Japan

    Tsutomu Tanaka & Shigeo Nakamura

  3. Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan

    Kazuyuki Shimada & Tomohiro Kinoshita

  4. Department of Hematology and Cell Therapy, Aichi Cancer Center, Nagoya, Japan

    Kazuhito Yamamoto

  5. Department of Endoscopy, Aichi Cancer Center, Nagoya, Japan

    Yasumasa Niwa

  6. Department of Hematology, Toyohashi Municipal Hospital, Toyohashi, Japan

    Isamu Sugiura

  7. Department of Hematology, Ichinomiya Municipal Hospital, Ichinomiya, Japan

    Kunio Kitamura

  8. Department of Hematology, Ogaki Municipal Hospital, Ogaki, Japan

    Hiroshi Kosugi

Authors
  1. Tsutomu Tanaka
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  2. Kazuyuki Shimada
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  3. Kazuhito Yamamoto
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  4. Yoshiki Hirooka
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  5. Yasumasa Niwa
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  6. Isamu Sugiura
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  7. Kunio Kitamura
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  8. Hiroshi Kosugi
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  9. Tomohiro Kinoshita
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  10. Hidemi Goto
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  11. Shigeo Nakamura
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Correspondence to Tsutomu Tanaka.

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Tanaka, T., Shimada, K., Yamamoto, K. et al. Retrospective analysis of primary gastric diffuse large B cell lymphoma in the rituximab era: a multicenter study of 95 patients in Japan. Ann Hematol 91, 383–390 (2012). https://doi.org/10.1007/s00277-011-1306-0

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  • DOI: https://doi.org/10.1007/s00277-011-1306-0

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