Biological Findings and Clinical Outcomes in Patients Treated With R‐CHOP Plus High‐Dose Methotrexate as First‐Line Therapy in Large B‐Cell Lymphoma With Testis Involvement

• Published in: European journal of haematology 2025-01, Vol.114 (1), p.186-194
• Main Authors: Liévin, R., Burroni, B., Balducci, E., Palmic, P., Decroocq, J., Deau‐Fischer, B., Franchi, P., Vignon, M., Zerbit, J., Cottereau, A. S., Touzart, A., Villarese, P., Kaltenbach, S., Lhermitte, L., Asnafi, V., Bouscary, D., Willems, L.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Antibodies, Monoclonal, Murine-Derived - administration & dosage; Antibodies, Monoclonal, Murine-Derived - adverse effects; Antibodies, Monoclonal, Murine-Derived - therapeutic use; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Central nervous system; CNS relapse; Cyclophosphamide - administration & dosage; Cyclophosphamide - therapeutic use; DLBCL; Doxorubicin - administration & dosage; Doxorubicin - therapeutic use; Humans; Lymphoma; Lymphoma, Large B-Cell, Diffuse - diagnosis; Lymphoma, Large B-Cell, Diffuse - drug therapy; Lymphoma, Large B-Cell, Diffuse - mortality; Male; Methotrexate; Methotrexate - administration & dosage; Methotrexate - therapeutic use; Middle Aged; Original; Prednisone - administration & dosage; Prednisone - therapeutic use; Remission; Rituximab - administration & dosage; Testicular Neoplasms - diagnosis; Testicular Neoplasms - drug therapy; Testicular Neoplasms - mortality; Testicular Neoplasms - pathology; testis; Treatment Outcome; Vincristine - administration & dosage; Vincristine - therapeutic use
• ISSN: 0902-4441; 1600-0609; 1600-0609
• DOI: 10.1111/ejh.14325

ABSTRACT Primary testicular lymphoma (PTL) is a rare occurrence of diffuse large B‐cell lymphoma (DLBCL) that accounts for 1%–2% of all cases. Nodal DLBCL with testis involvement (DLBCL‐T) and PTL are associated with poor prognosis, with high incidence of central nervous system relapse. Fifteen patients (median age 60 years) with PTL (n = 5) or DLBCL‐T (n = 10) received high‐dose methotrexate + R‐CHOP. Overall, complete response (CR) rate was 73% and overall response rate 86%. With a 3.9‐year median follow‐up, 100% of patients with PTL had CR and none relapsed. On the contrary, 55% of DLBCL‐T patients achieved CR among which only one was still in remission at the end of follow‐up. Molecular parallels between PTL and Primary CNS Lymphoma (PCNSL) suggest shared origins, urging further research for tailored treatments and enhanced understanding of these lymphomas' biology.