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

Tsutomu Tanaka, Kazuyuki Shimada, Kazuhito Yamamoto, Yoshiki Hirooka, Yasumasa Niwa, Isamu Sugiura, Kunio Kitamura, Hiroshi Kosugi, Tomohiro Kinoshita, Hidemi Goto, Shigeo Nakamura

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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.

Original languageEnglish
Pages (from-to)383-390
Number of pages8
JournalAnnals of Hematology
Volume91
Issue number3
DOIs
Publication statusPublished - 03-2012

All Science Journal Classification (ASJC) codes

  • Hematology

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    Tanaka, T., Shimada, K., Yamamoto, K., Hirooka, Y., Niwa, Y., Sugiura, I., Kitamura, K., Kosugi, H., Kinoshita, T., Goto, H., & Nakamura, S. (2012). Retrospective analysis of primary gastric diffuse large B cell lymphoma in the rituximab era: A multicenter study of 95 patients in Japan. Annals of Hematology, 91(3), 383-390. https://doi.org/10.1007/s00277-011-1306-0