A multicentre study of primary breast diffuse large B-cell lymphoma in the rituximab era

Peter Hosein, Jocelyn C. Maragulia, Matthew P. Salzberg, Oliver W. Press, Thomas M. Habermann, Julie M. Vose, Martin Bast, Ranjana H. Advani, Robert Tibshirani, Andrew M. Evens, Nahida Islam, John P. Leonard, Peter Martin, Andrew D. Zelenetz, Izidore Lossos

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

Summary: Primary breast diffuse large B-cell lymphoma (DLBCL) is a rare subtype of non-Hodgkin lymphoma (NHL) with limited data on pathology and outcome. A multicentre retrospective study was undertaken to determine prognostic factors and the incidence of central nervous system (CNS) relapses. Data was retrospectively collected on patients from 8 US academic centres. Only patients with stage I/II disease (involvement of breast and localized lymph nodes) were included. Histologies apart from primary DLBCL were excluded. Between 1992 and 2012, 76 patients met the eligibility criteria. Most patients (86%) received chemotherapy, and 69% received immunochemotherapy with rituximab; 65% received radiation therapy and 9% received prophylactic CNS chemotherapy. After a median follow-up of 4·5 years (range 0·6-20·6 years), the Kaplan-Meier estimated median progression-free survival was 10·4 years (95% confidence interval [CI] 5·8-14·9 years), and the median overall survival was 14·6 years (95% CI 10·2-19 years). Twelve patients (16%) had CNS relapse. A low stage-modified International Prognostic Index (IPI) was associated with longer overall survival. Rituximab use was not associated with a survival advantage. Primary breast DLBCL has a high rate of CNS relapse. The stage-modified IPI score is associated with survival.

Original languageEnglish
Pages (from-to)358-363
Number of pages6
JournalBritish Journal of Haematology
Volume165
Issue number3
DOIs
StatePublished - Jan 1 2014

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Lymphoma, Large B-Cell, Diffuse
Multicenter Studies
Breast
Central Nervous System
Survival
Recurrence
Confidence Intervals
Drug Therapy
Breast Diseases
Non-Hodgkin's Lymphoma
Disease-Free Survival
Histology
Radiotherapy
Retrospective Studies
Lymph Nodes
Rituximab
Pathology
Incidence

Keywords

  • Breast
  • Central nervous system
  • Diffuse large B-cell lymphoma
  • Lymphoma
  • Rituximab

ASJC Scopus subject areas

  • Hematology

Cite this

A multicentre study of primary breast diffuse large B-cell lymphoma in the rituximab era. / Hosein, Peter; Maragulia, Jocelyn C.; Salzberg, Matthew P.; Press, Oliver W.; Habermann, Thomas M.; Vose, Julie M.; Bast, Martin; Advani, Ranjana H.; Tibshirani, Robert; Evens, Andrew M.; Islam, Nahida; Leonard, John P.; Martin, Peter; Zelenetz, Andrew D.; Lossos, Izidore.

In: British Journal of Haematology, Vol. 165, No. 3, 01.01.2014, p. 358-363.

Research output: Contribution to journalArticle

Hosein, P, Maragulia, JC, Salzberg, MP, Press, OW, Habermann, TM, Vose, JM, Bast, M, Advani, RH, Tibshirani, R, Evens, AM, Islam, N, Leonard, JP, Martin, P, Zelenetz, AD & Lossos, I 2014, 'A multicentre study of primary breast diffuse large B-cell lymphoma in the rituximab era', British Journal of Haematology, vol. 165, no. 3, pp. 358-363. https://doi.org/10.1111/bjh.12753
Hosein, Peter ; Maragulia, Jocelyn C. ; Salzberg, Matthew P. ; Press, Oliver W. ; Habermann, Thomas M. ; Vose, Julie M. ; Bast, Martin ; Advani, Ranjana H. ; Tibshirani, Robert ; Evens, Andrew M. ; Islam, Nahida ; Leonard, John P. ; Martin, Peter ; Zelenetz, Andrew D. ; Lossos, Izidore. / A multicentre study of primary breast diffuse large B-cell lymphoma in the rituximab era. In: British Journal of Haematology. 2014 ; Vol. 165, No. 3. pp. 358-363.
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AU - Habermann, Thomas M.

AU - Vose, Julie M.

AU - Bast, Martin

AU - Advani, Ranjana H.

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AU - Evens, Andrew M.

AU - Islam, Nahida

AU - Leonard, John P.

AU - Martin, Peter

AU - Zelenetz, Andrew D.

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AB - Summary: Primary breast diffuse large B-cell lymphoma (DLBCL) is a rare subtype of non-Hodgkin lymphoma (NHL) with limited data on pathology and outcome. A multicentre retrospective study was undertaken to determine prognostic factors and the incidence of central nervous system (CNS) relapses. Data was retrospectively collected on patients from 8 US academic centres. Only patients with stage I/II disease (involvement of breast and localized lymph nodes) were included. Histologies apart from primary DLBCL were excluded. Between 1992 and 2012, 76 patients met the eligibility criteria. Most patients (86%) received chemotherapy, and 69% received immunochemotherapy with rituximab; 65% received radiation therapy and 9% received prophylactic CNS chemotherapy. After a median follow-up of 4·5 years (range 0·6-20·6 years), the Kaplan-Meier estimated median progression-free survival was 10·4 years (95% confidence interval [CI] 5·8-14·9 years), and the median overall survival was 14·6 years (95% CI 10·2-19 years). Twelve patients (16%) had CNS relapse. A low stage-modified International Prognostic Index (IPI) was associated with longer overall survival. Rituximab use was not associated with a survival advantage. Primary breast DLBCL has a high rate of CNS relapse. The stage-modified IPI score is associated with survival.

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