Malignant effusions correlate with poorer prognosis in patients with diffuse large B-cell Lymphoma

Ya-Ping Chen, Huai Yi Huang, Kun Piao Lin, L. Jeffrey Medeiros, Tsai-Yun Chen, Kung-Chao Chang

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Objectives: Serous effusions are a common manifestation of diffuse large B-cell lymphoma (DLBCL). However, their prognostic significance is controversial. Methods: We searched for consecutive patients who had DLBCL with effusions from 1999 through 2007. Primary effusion lymphoma was excluded. The presence of tumor cells in effusions (malignant effusions) was determined by cytology supplemented by flow cytometry, cell blocks with special studies, polymerase chain reaction for clonality, or conventional cytogenetics. Results: Forty-one (18.4%) patients had effusions, with 24 (58.5%) developing at diagnosis and 17 (41.5%) during tumor course. Nineteen patients (46.0%) had malignant effusions, with six (31.6%) from local extension and 13 (68.4%) through wide dissemination. Interestingly, malignant effusion correlated with a high International Prognostic Index (IPI) score (r = 0.490, P = .002) and high tumor stage (r = 0.342, P = .031) and was a poor prognosticator (P < .001, log-rank test), even worse than stage IV disease (P = .036). In the multivariate analysis, malignant effusion (P = .056) and supportive care (P = .014) retained significance and were more powerful than IPI score and stage. Conclusions: Patients who have DLBCL with lymphomatous effusions have a poor prognosis and should be treated as having stage IV disease. The analysis of effusions for tumor cells would be a useful addition to the routine workup.

Original languageEnglish
Pages (from-to)707-715
Number of pages9
JournalAmerican Journal of Clinical Pathology
Volume143
Issue number5
DOIs
Publication statusPublished - 2015 May 1

Fingerprint

Lymphoma, Large B-Cell, Diffuse
Neoplasms
Primary Effusion Lymphoma
Cytogenetics
Cell Biology
Flow Cytometry
Multivariate Analysis
Polymerase Chain Reaction

All Science Journal Classification (ASJC) codes

  • Pathology and Forensic Medicine

Cite this

@article{6d3967c099b44982b5b31816effa0abf,
title = "Malignant effusions correlate with poorer prognosis in patients with diffuse large B-cell Lymphoma",
abstract = "Objectives: Serous effusions are a common manifestation of diffuse large B-cell lymphoma (DLBCL). However, their prognostic significance is controversial. Methods: We searched for consecutive patients who had DLBCL with effusions from 1999 through 2007. Primary effusion lymphoma was excluded. The presence of tumor cells in effusions (malignant effusions) was determined by cytology supplemented by flow cytometry, cell blocks with special studies, polymerase chain reaction for clonality, or conventional cytogenetics. Results: Forty-one (18.4{\%}) patients had effusions, with 24 (58.5{\%}) developing at diagnosis and 17 (41.5{\%}) during tumor course. Nineteen patients (46.0{\%}) had malignant effusions, with six (31.6{\%}) from local extension and 13 (68.4{\%}) through wide dissemination. Interestingly, malignant effusion correlated with a high International Prognostic Index (IPI) score (r = 0.490, P = .002) and high tumor stage (r = 0.342, P = .031) and was a poor prognosticator (P < .001, log-rank test), even worse than stage IV disease (P = .036). In the multivariate analysis, malignant effusion (P = .056) and supportive care (P = .014) retained significance and were more powerful than IPI score and stage. Conclusions: Patients who have DLBCL with lymphomatous effusions have a poor prognosis and should be treated as having stage IV disease. The analysis of effusions for tumor cells would be a useful addition to the routine workup.",
author = "Ya-Ping Chen and Huang, {Huai Yi} and Lin, {Kun Piao} and Medeiros, {L. Jeffrey} and Tsai-Yun Chen and Kung-Chao Chang",
year = "2015",
month = "5",
day = "1",
doi = "10.1309/AJCP6LXA2LKFZAMC",
language = "English",
volume = "143",
pages = "707--715",
journal = "American Journal of Clinical Pathology",
issn = "0002-9173",
publisher = "American Society of Clinical Pathologists",
number = "5",

}

Malignant effusions correlate with poorer prognosis in patients with diffuse large B-cell Lymphoma. / Chen, Ya-Ping; Huang, Huai Yi; Lin, Kun Piao; Medeiros, L. Jeffrey; Chen, Tsai-Yun; Chang, Kung-Chao.

In: American Journal of Clinical Pathology, Vol. 143, No. 5, 01.05.2015, p. 707-715.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Malignant effusions correlate with poorer prognosis in patients with diffuse large B-cell Lymphoma

AU - Chen, Ya-Ping

AU - Huang, Huai Yi

AU - Lin, Kun Piao

AU - Medeiros, L. Jeffrey

AU - Chen, Tsai-Yun

AU - Chang, Kung-Chao

PY - 2015/5/1

Y1 - 2015/5/1

N2 - Objectives: Serous effusions are a common manifestation of diffuse large B-cell lymphoma (DLBCL). However, their prognostic significance is controversial. Methods: We searched for consecutive patients who had DLBCL with effusions from 1999 through 2007. Primary effusion lymphoma was excluded. The presence of tumor cells in effusions (malignant effusions) was determined by cytology supplemented by flow cytometry, cell blocks with special studies, polymerase chain reaction for clonality, or conventional cytogenetics. Results: Forty-one (18.4%) patients had effusions, with 24 (58.5%) developing at diagnosis and 17 (41.5%) during tumor course. Nineteen patients (46.0%) had malignant effusions, with six (31.6%) from local extension and 13 (68.4%) through wide dissemination. Interestingly, malignant effusion correlated with a high International Prognostic Index (IPI) score (r = 0.490, P = .002) and high tumor stage (r = 0.342, P = .031) and was a poor prognosticator (P < .001, log-rank test), even worse than stage IV disease (P = .036). In the multivariate analysis, malignant effusion (P = .056) and supportive care (P = .014) retained significance and were more powerful than IPI score and stage. Conclusions: Patients who have DLBCL with lymphomatous effusions have a poor prognosis and should be treated as having stage IV disease. The analysis of effusions for tumor cells would be a useful addition to the routine workup.

AB - Objectives: Serous effusions are a common manifestation of diffuse large B-cell lymphoma (DLBCL). However, their prognostic significance is controversial. Methods: We searched for consecutive patients who had DLBCL with effusions from 1999 through 2007. Primary effusion lymphoma was excluded. The presence of tumor cells in effusions (malignant effusions) was determined by cytology supplemented by flow cytometry, cell blocks with special studies, polymerase chain reaction for clonality, or conventional cytogenetics. Results: Forty-one (18.4%) patients had effusions, with 24 (58.5%) developing at diagnosis and 17 (41.5%) during tumor course. Nineteen patients (46.0%) had malignant effusions, with six (31.6%) from local extension and 13 (68.4%) through wide dissemination. Interestingly, malignant effusion correlated with a high International Prognostic Index (IPI) score (r = 0.490, P = .002) and high tumor stage (r = 0.342, P = .031) and was a poor prognosticator (P < .001, log-rank test), even worse than stage IV disease (P = .036). In the multivariate analysis, malignant effusion (P = .056) and supportive care (P = .014) retained significance and were more powerful than IPI score and stage. Conclusions: Patients who have DLBCL with lymphomatous effusions have a poor prognosis and should be treated as having stage IV disease. The analysis of effusions for tumor cells would be a useful addition to the routine workup.

UR - http://www.scopus.com/inward/record.url?scp=84937107442&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84937107442&partnerID=8YFLogxK

U2 - 10.1309/AJCP6LXA2LKFZAMC

DO - 10.1309/AJCP6LXA2LKFZAMC

M3 - Article

C2 - 25873505

AN - SCOPUS:84937107442

VL - 143

SP - 707

EP - 715

JO - American Journal of Clinical Pathology

JF - American Journal of Clinical Pathology

SN - 0002-9173

IS - 5

ER -