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

研究成果: Article

13 引文 斯高帕斯(Scopus)

摘要

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.

原文English
頁(從 - 到)707-715
頁數9
期刊American Journal of Clinical Pathology
143
發行號5
DOIs
出版狀態Published - 2015 五月 1

All Science Journal Classification (ASJC) codes

  • Pathology and Forensic Medicine

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