title: CD5-positive diffuse large B-cell lymphoma: a retrospective study in 337 patients treated by chemotherapy with or without rituximab.
abstract: BACKGROUND
  CD5-positive (CD5+) diffuse large B-cell lymphoma (DLBCL) shows poor prognosis and frequent central nervous system (CNS) relapses under anthracycline-containing chemotherapy. The aim of this study was to determine the prognosis and CNS relapse incidence of CD5+ DLBCL in the rituximab era.
  
  
  METHODS
  We analyzed 337 patients with CD5+ DLBCL who received chemotherapy with (R-chemotherapy group; n = 184) or without (chemotherapy group; n = 153) rituximab.
  
  
  RESULTS
  No significant difference was found in clinical background comparisons between the two groups. In the R-chemotherapy group, 60% of the patients were older than 65 years at diagnosis. Both the complete response rate and overall survival (OS) were significantly better in the R-chemotherapy group (P = 0.0003 and P = 0.002, respectively). Multivariate analysis confirmed that chemotherapy without rituximab was associated with unfavorable OS. However, the probability of CNS relapse did not differ between the two groups (P = 0.89). The CNS relapse was strongly associated with short OS (P < 0.0001). In the R-chemotherapy group, 83% of patients who experienced CNS relapse had parenchymal disease.
  
  
  CONCLUSIONS
  Our results indicate that rituximab improves the OS of patients with CD5+ DLBCL but does not decrease the CNS relapse rate. More effective treatments with CNS prophylaxis are needed for CD5+ DLBCL patients.
authors.affiliation: Department of Hematology and Oncology, Mie University Graduate School of Medicine, Tsu.
authors.forename: K
authors.initials: K
authors.lastname: Miyazaki
authors.affiliation: Department of Hematology and Oncology, Mie University Graduate School of Medicine, Tsu. Electronic address: waniwani@clin.medic.mie-u.ac.jp.
authors.forename: M
authors.initials: M
authors.lastname: Yamaguchi
authors.affiliation: Department of HSCT Data Management and Biostatistics, Nagoya University Graduate School of Medicine, Nagoya.
authors.forename: R
authors.initials: R
authors.lastname: Suzuki
authors.affiliation: Hematology and Stem Cell Transplantation Division.
authors.forename: Y
authors.initials: Y
authors.lastname: Kobayashi
authors.affiliation: Clinical Laboratory Division, National Cancer Center Hospital, Tokyo.
authors.forename: A M
authors.initials: AM
authors.lastname: Maeshima
authors.affiliation: Department of Hematology, International Medical Center, Saitama Medical University, Hidaka.
authors.forename: N
authors.initials: N
authors.lastname: Niitsu
authors.affiliation: Department of Medical Oncology, Cancer Institute Hospital, Tokyo.
authors.forename: D
authors.initials: D
authors.lastname: Ennishi
authors.affiliation: Department of Pathology, Saitama Medical Center, Saitama Medical University, Kawagoe.
authors.forename: J-I
authors.initials: JI
authors.lastname: Tamaru
authors.affiliation: Department of Hematology and Rheumatology, Tohoku University Hospital, Sendai.
authors.forename: K
authors.initials: K
authors.lastname: Ishizawa
authors.affiliation: Department of Hematology, Matsudo City Hospital, Matsudo.
authors.forename: M
authors.initials: M
authors.lastname: Kashimura
authors.affiliation: Department of Hematology and Cell Therapy, Aichi Cancer Center Hospital, Nagoya.
authors.forename: Y
authors.initials: Y
authors.lastname: Kagami
authors.affiliation: Department of Hematology, National Hospital Organization Okayama Medical Center, Okayama.
authors.forename: K
authors.initials: K
authors.lastname: Sunami
authors.affiliation: Division of Clinical Oncology, Sumitomo-Besshi Hospital Cancer Center, Niihama.
authors.forename: H
authors.initials: H
authors.lastname: Yamane
authors.affiliation: Department of Hematology and Oncology, Kyoto University, Kyoto.
authors.forename: M
authors.initials: M
authors.lastname: Nishikori
authors.affiliation: Department of Hematology, Ogaki Municipal Hospital, Ogaki.
authors.forename: H
authors.initials: H
authors.lastname: Kosugi
authors.affiliation: Department of Hematology, Yamaguchi University, Yamaguchi.
authors.forename: T
authors.initials: T
authors.lastname: Yujiri
authors.affiliation: Department of HSCT Data Management and Biostatistics, Nagoya University Graduate School of Medicine, Nagoya.
authors.forename: R
authors.initials: R
authors.lastname: Hyo
authors.affiliation: Department of Hematology and Oncology, Mie University Graduate School of Medicine, Tsu.
authors.forename: N
authors.initials: N
authors.lastname: Katayama
authors.affiliation: Departments of Hematology and Oncology.
authors.forename: T
authors.initials: T
authors.lastname: Kinoshita
authors.affiliation: Pathology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Nakamura
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000378:metabolism / Q000556:secondary; D018956:CD5 Antigens / Q000378:metabolism*; D003520:Cyclophosphamide / Q000008:administration & dosage; D004317:Doxorubicin / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D011241:Prednisone / Q000008:administration & dosage; D012074:Remission Induction; D012189:Retrospective Studies; D000069283:Rituximab; D015996:Survival Rate; D016896:Treatment Outcome; D014750:Vincristine / Q000008:administration & dosage; D055815:Young Adult
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D018956:CD5 Antigens; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone