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

• Published in: British journal of haematology 2014-05, Vol.165 (3), p.358-363
• Main Authors: Hosein, Peter J., 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 S.
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Antibodies, Monoclonal, Murine-Derived - therapeutic use; Antineoplastic Agents - therapeutic use; Biological and medical sciences; breast; Breast Neoplasms - drug therapy; Breast Neoplasms - pathology; central nervous system; diffuse large B‐cell lymphoma; Disease-Free Survival; Female; Hematologic and hematopoietic diseases; Humans; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; lymphoma; Lymphoma, Large B-Cell, Diffuse - drug therapy; Lymphoma, Large B-Cell, Diffuse - pathology; Medical sciences; Middle Aged; Retrospective Studies; Rituximab; Survival Analysis; Tumors; Young Adult
• ISSN: 0007-1048; 1365-2141
• DOI: 10.1111/bjh.12753

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.