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Some patients with diffuse large B-cell lymphoma (DLBCL) present with a concurrent indolent lymphoma at diagnosis. Their outcomes in the rituximab era are not fully defined. Using a prospectively followed cohort of 1324 newly diagnosed DLBCL patients treated with immunochemotherapy, we defined the prevalence, characteristics, and outcome of DLBCL with concurrent indolent lymphoma. Compared with patients with DLBCL alone (n = 1153; 87.1%), patients with concurrent DLBCL and follicular lymphoma (FL) (n = 109; 8.2%) had fewer elevations in lactate dehydrogenase, lower International Prognostic Index (IPI), and predominantly germinal center B-cell-like (GCB) subtype, whereas patients with concurrent DLBCL and other indolent lymphomas (n = 62; 4.7%) had more stage III-IV disease and a trend toward higher IPI and non-GCB subtype. After adjusting for IPI, patients with concurrent DLBCL and FL had similar event-free survival (EFS) (hazard ratio [HR] = 0.95) and a trend of better overall survival (OS) (HR = 0.75) compared with patients with DLBCL alone, but nearly identical EFS (HR = 1.00) and OS (HR = 0.84) compared with patients with GCB DLBCL alone. Patients with concurrent DLBCL and other indolent lymphomas had similar EFS (HR = 1.19) and OS (HR = 1.09) compared with patients with DLBCL alone. In conclusion, DLBCL patients with concurrent FL predominantly had the GCB subtype with outcomes similar to that of GCB DLBCL patients. DLBCL patients with concurrent other indolent lymphoma had similar outcomes compared with patients with DLBCL alone. These patients should not be summarily excluded from DLBCL clinical trials.

Titel:	Impact of concurrent indolent lymphoma on the clinical outcome of newly diagnosed diffuse large B-cell lymphoma.
Autor/in / Beteiligte Person:	Wang, Y ; Link, BK ; Witzig, TE ; Maurer, MJ ; Allmer, C ; King, RL ; Feldman, AL ; Habermann, TM ; Ansell, SM ; Slager, SL ; Cerhan, JR ; Nowakowski, GS
Link:	Full Text Finder (Volltext)
Zeitschrift:	Blood, Jg. 134 (2019-10-17), Heft 16, S. 1289-1297
Veröffentlichung:	2021- : [New York] : Elsevier ; <i>Original Publication</i>: New York, Grune & Stratton [etc.], 2019
Medientyp:	academicJournal
ISSN:	1528-0020 (electronic)
DOI:	10.1182/blood.2019000858
Schlagwort:	Aged Aged, 80 and over Female Humans Lymphoma pathology Lymphoma, Large B-Cell, Diffuse pathology Male Middle Aged Neoplasms, Multiple Primary pathology Progression-Free Survival Lymphoma mortality Lymphoma, Large B-Cell, Diffuse mortality Neoplasms, Multiple Primary mortality
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't Language: English [Blood] 2019 Oct 17; Vol. 134 (16), pp. 1289-1297. MeSH Terms: Lymphoma / mortality ; Lymphoma, Large B-Cell, Diffuse / mortality ; Neoplasms, Multiple Primary / *mortality ; Aged ; Aged, 80 and over ; Female ; Humans ; Lymphoma / pathology ; Lymphoma, Large B-Cell, Diffuse / pathology ; Male ; Middle Aged ; Neoplasms, Multiple Primary / pathology ; Progression-Free Survival Comments: Comment in: Blood. 2019 Oct 17;134(16):1273-1274. (PMID: 31698435) References: Ann Oncol. 2017 Nov 1;28(11):2799-2805. (PMID: 29045517) ; Ann Oncol. 2015 Feb;26(2):393-9. (PMID: 25411416) ; J Clin Oncol. 2006 Nov 20;24(33):5234-41. (PMID: 17043351) ; Blood. 2007 Aug 15;110(4):1278-82. (PMID: 17475910) ; N Engl J Med. 2008 Nov 27;359(22):2313-23. (PMID: 19038878) ; Int J Epidemiol. 2017 Dec 1;46(6):1753-1754i. (PMID: 29025017) ; Oncotarget. 2018 Apr 13;9(28):19613-19622. (PMID: 29731969) ; J Clin Oncol. 2011 Apr 10;29(11):1452-7. (PMID: 21383296) ; Blood. 2004 Jan 1;103(1):275-82. (PMID: 14504078) ; J Clin Pathol. 2015 Sep;68(9):733-8. (PMID: 25998512) ; Leukemia. 2018 Feb;32(2):353-363. (PMID: 28745330) ; Br J Haematol. 2011 Mar;152(5):600-10. (PMID: 21241276) ; Clin Lymphoma Myeloma Leuk. 2012 Dec;12(6):406-11. (PMID: 22981964) ; Eur J Haematol. 2006 Jun;76(6):473-80. (PMID: 16529599) ; Blood. 2015 Aug 13;126(7):851-7. (PMID: 26105149) ; Blood. 2011 May 5;117(18):4836-43. (PMID: 21441466) ; Lab Invest. 2003 Jan;83(1):107-14. (PMID: 12533691) ; J Clin Pathol. 2013 May;66(5):420-5. (PMID: 23610041) ; J Clin Oncol. 1990 Jul;8(7):1163-72. (PMID: 1694234) ; Blood. 2010 Dec 2;116(23):4916-25. (PMID: 20736456) ; Leuk Lymphoma. 2012 May;53(5):830-5. (PMID: 22023518) ; J Clin Oncol. 2013 Sep 10;31(26):3272-8. (PMID: 23897955) Grant Information: P30 CA086862 United States CA NCI NIH HHS; P50 CA097274 United States CA NCI NIH HHS; U01 CA195568 United States CA NCI NIH HHS Entry Date(s): Date Created: 20190728 Date Completed: 20200205 Latest Revision: 20210202 Update Code: 20231215 PubMed Central ID: PMC6888139

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Impact of concurrent indolent lymphoma on the clinical outcome of newly diagnosed diffuse large B-cell lymphoma.