Annals of Oncology 12:53-58, 2001
© 2001 European Society for Medical Oncology
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Primary intestinal diffuse large B-cell non-Hodgkin's lymphoma: Clinical features, management, and prognosis of 66 patients
1Departments of Oncology,King Faisal Specialist Hospital &Research Centre Riyadh. Saudi Arabia.
2Departments of Pathology, King Faisal Specialist Hospital & Research Centre Riyadh. Saudi Arabia
3Instituto Oncologico delta Svizzera Itahana, Ospedale San Giovanni Bellinzona, Switzeland
E M Ibrahim, MD Department of Oncology (MBC/64) King Faisal Specialist Hospital and Research Center PO Box 3354, Riyadh 11211 Kingdom of Saudi Arabia E-mailezzibrahim{at}kfshrc.edu.sa
BACKGROUND: In Saudi Arabia, primary gastrointestinal non-Hodgkin's lymphoma (NHL) is common. Recently we have reported one of the largest series of primary gastric (PG) diffuse large B-cell lymphoma (DLCL) This has prompted the analysis of another series of patients with primary intestinal DLCL to depict the clinical features and the outcome of that disease and to compare those with that for PG involvement
PATIENTS AND METHODS: The data of 66 adult patients with primary intestinal NHL having DLCL histology were retrospectively reviewed
RESULTS: Patients had a median age of 45 years Of 64 treated patients, 16% and 84% received single and multiple modality treatment, respectively Seventy-six percent, ten percent, and fourteen percent attained complete remission (CR), partial remission (PR), and no response/progressive disease, respectively Multivanate analysis failed to identify any variable that predict the likelihood of attaining CR Over a median follow-up of 81 months for all 66 patients, 32 (48%) were alive and disease-free, 5 (8%) were alive with evidence of disease, and the remaining 29 (44%) were dead The median overall survival (OS) was 101 months and it was 58% (±6%) and 48% (±7%) at 5- and 10-year, respectively. Of the 54 patients who achieved CR or PR, the median event-free survival (EFS) was not reached, but the predicted 5- and 10-year EFS was 61% (±7%) and 52% (±7%), respectively. Only low serum albumin (<30 g/l) was associated with adverse OS and EFS in a univanate analysis, however, multivanate analysis was not possible Our analysis showed that compared with single-modality management, multi-modality strategy attained significantly higher CR, and advantageous EFS, but without a significant superior effect on OS In comparison with patients with PG DLCL, those with primary intestinal disease demonstrated more adverse prognostic features, but had an equivalent survival
CONCLUSIONS: This series characterized the chnico-pathologic features and outcome of patients with primary intestinal DLCL. While surgical resection in primary intestinal NHL seems beneficial, only prospective randomized studies can ascertain its precise role Compared with patients with PG NHL, patients with primary intestinal disease had more prevalence of adverse prognostic features
intestinal, non-Hodgkin's lymphoma, primary
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  S. Daum, R. Ullrich, W. Heise, B. Dederke, H.-D. Foss, H. Stein, E. Thiel, M. Zeitz, and E.-O. Riecken Intestinal Non-Hodgkin's Lymphoma: A Multicenter Prospective Clinical Study From the German Study Group on Intestinal Non-Hodgkin's Lymphoma J. Clin. Oncol., July 15, 2003; 21(14): 2740 - 2746. [Abstract] [Full Text] [PDF]
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