Journal of Clinical Oncology, 2005 ASCO Annual Meeting Proceedings.
Vol 23, No 16S (June 1 Supplement), 2005: 6733
© 2005 American Society of Clinical Oncology

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Abstract

Primary mediastinal large B-Cell lymphoma: A condition with poor prognosis. A case series study from Iranian National Research Institute of TB & Lung Disease

National Research Inst. of TB & Lung Disease, Tehran, Iran (Islamic Republic of)

6733

Background: Primary mediastinal large B-cell lymphoma (PMLBL) is thought by some to be a distinct disease entity with bulky mediastinal mass and low-stage disease. There is a female predominance and a median age of diagnosis in the fourth decade. Based on the majority reports from western countries; this type of lymphoma has dramatic response to combination chemotherapy and mediastinal radiotherapy, although controversy exists regarding the response to therapy and prognosis. The purpose of this study is to evaluate the efficacy of a combined modality treatment, and determining the objective overall survival and disease-free survival in the patients with PMLBL. Methods: Between 2000 and 2004, 17 patients with PMLBL have been admitted in our center. Fifteen of these patients underwent one of two standard chemotherapy regimens (CHOP, 8 cycles or MACOP-B) combining with mediastinal radiotherapy. Retrospectively, we evaluated the response rate, disease free survival and overall survival. Two patients were not accessible for treatment evaluation. Results: In the 17 patients with PMLBL, male to female ratio was 10:7 and a median age of 31 years. Stage I/II disease was present in 82.8% of patients without any bone marrow involvement. Among 15 treated patients complete response, partial response, stable disease and progressive disease were 73.3% (11/15), 6.6% (1/15), 13.2% (2/15) and 6.6% (1/15), respectively. Five patients (5/12, 41.6%) in responder group were relapsed. Median overall survival was 26 months. One-year and 2-year overall survival were 58.7% and 17.6%, respectively. Failure-free survival was 19.2 months. Conclusions: Although a very limited patients have been evaluated in our study but it seems that the prognosis is so grave in our group compare to western reports. It is interesting that in our study there was male predominance. We speculate that the nature of PMLBL is different from western type of this disease. Based on our experience this kind of lymphoma in our country demands more aggressive approach and the patients may benefit autologous stem cell transplantation after achieving complete remission.

No significant financial relationships to disclose.