Uterine, but not ovarian, female reproductive organ involvement at presentation by diffuse large B-cell lymphoma is associated with poor outcomes and a high frequency of secondary CNS involvement

TC El-Galaly, Chan Cheah, M Hutchings, NG Mikhaeel, KJ Savage, LH Sehn, S Barrington, JW Hansen, MO Poulsen, D Smith, K Rady, KJ Mylam, TS Larsen, S Holmberg, MB Juul, S Cordua, MR Clausen, KB Jensen, M Bogsted, HE JohnsenJF Seymour, JM Connors, PdN N Brown, D Villa

Research output: Contribution to journalArticlepeer-review

18 Citations (Scopus)

Abstract

Involvement of the internal female reproductive organs by diffuse large B-cell lymphoma (DLBCL) is uncommon, and there are sparse data describing the outcomes of such cases. In total, 678 female patients with DLBCL staged with positron emission tomography/computed tomography and treated with rituximab-containing chemotherapy were identified from databases in Denmark, Great Britain, Australia, and Canada. Overall, 27/678 (4%) had internal reproductive organ involvement: uterus (n = 14), ovaries (n = 10) or both (n = 3). In multivariate analysis, women with uterine DLBCL experienced inferior progression-free survival and overall survival compared to those without reproductive organ involvement, whereas ovarian DLBCL was not predictive of outcome. Secondary central nervous system (CNS) involvement (SCNS) occurred in 7/17 (41%) women with uterine DLBCL (two patients with concomitant ovarian DLBCL) and 0/10 women with ovarian DLBCL without concomitant uterine involvement. In multivariate analysis adjusted for other risk factors for SCNS, uterine involvement by DLBCL remained strongly associated with SCNS (Hazard ratio 14·13, 95% confidence interval 5·09–39·25, P < 0·001). Because involvement of the uterus by DLBCL appears to be associated with a high risk of SCNS, those patients should be considered for CNS staging and prophylaxis. However, more studies are needed to determine whether the increased risk of secondary CNS involvement also applies to women with localized reproductive organ DLBCL. © 2016 John Wiley & Sons Ltd
Original languageEnglish
Pages (from-to)876-883
Number of pages8
JournalBritish Journal of Haematology
Volume175
Issue number5
Publication statusPublished - 2016

Fingerprint

Dive into the research topics of 'Uterine, but not ovarian, female reproductive organ involvement at presentation by diffuse large B-cell lymphoma is associated with poor outcomes and a high frequency of secondary CNS involvement'. Together they form a unique fingerprint.

Cite this