title: Analysis of clinical and immunophenotypic features along with treatment outcomes of diffuse large B cell lymphoma patients, based on the involvement of nodal or extranodal primary sites.
abstract: OBJECTIVE
  The aim of the present study was to elucidate the clinical features, immunophenotype and treatment outcomes of diffuse large B cell lymphoma (DLBCL) patients based on the involvement of the primary site i.e. lymph node or specific extranodal sites.
  
  
  METHODS
  We analyzed the clinical characteristics, immunophenotype and treatment outcomes of 207 DLBCL patients diagnosed in China between 2007 and 2014 based on the primary site of location.
  
  
  RESULTS
  Based on the involvement of primary site of occurrence, DLBCL cases, were classified into different groups like, lymph node (60 cases, 28.98%), gastrointestinal tract (GI) (53 cases, 25.60%), Waldeyer's ring (WR) (31 cases, 14.97%), gland (25 cases, 12.08%), and other extranodal sites (38 cases, 18.36%). Patients with WR involvement were more frequently associated with early stage disease, favorable performance status, absence of bulky disease, normal LDH and ESR levels, and low- or low/intermediate-risk IPI than the other groups. The proportion of DLBCL patients with germinal center B cell (GCB) phenotype was 56.0% for WR, 46.5% for GI, 34.5% for lymph node, 27.8% for other extranodal sites, and 18.2% for gland (P=0.035). The 5-year overall survival (OS) of the entire patient population was 71.1%, and WR group showed a better outcome than nodal group (84.9% vs. 55.9%, P=0.015). In multivariate analysis, bulky disease, bone marrow infiltration, non-GCB phenotype, intermediate/high- or high-risk IPI and SD/PD/Death after first therapy were identified as independent factors for poor OS, while regular application of rituximab and remission after first therapy were identified as favorable prognostic factors for PFS.
  
  
  CONCLUSIONS
  In this study, WR involvement was associated with more favorable clinical & pathological features along with better outcome than nodal lymphoma. The OS and PFS were largely dependent on other prognostic variables such as IPI or immunophenotype instead of the sites of involvement.
authors: Department of Cancer Center, The First Hospital of Jilin University, NO 76, Xin min Street, Changchun 130021, Jilin Province, China.
authors: Cong
authors: C
authors: Wang
authors: Department of Cancer Center, The First Hospital of Jilin University, NO 76, Xin min Street, Changchun 130021, Jilin Province, China.
authors: Wei
authors: W
authors: Li
authors: Department of Cancer Center, The First Hospital of Jilin University, NO 76, Xin min Street, Changchun 130021, Jilin Province, China.
authors: Chunshui
authors: C
authors: Liu
authors: Department of Cancer Center, The First Hospital of Jilin University, NO 76, Xin min Street, Changchun 130021, Jilin Province, China.
authors: Hua
authors: H
authors: He
authors: Department of Cancer Center, The First Hospital of Jilin University, NO 76, Xin min Street, Changchun 130021, Jilin Province, China. Electronic address: oubai1689@163.com.
authors: Ou
authors: O
authors: Bai
mesh_terms: D000368:Aged; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001402:B-Lymphocytes / Q000187:drug effects / Q000276:immunology / Q000473:pathology; D014408:Biomarkers, Tumor / Q000235:genetics* / Q000276:immunology; D001853:Bone Marrow / Q000187:drug effects / Q000276:immunology / Q000473:pathology; D003520:Cyclophosphamide / Q000627:therapeutic use; D004268:DNA-Binding Proteins / Q000235:genetics / Q000276:immunology; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D015870:Gene Expression; D006801:Humans; D016130:Immunophenotyping; D050835:Interferon Regulatory Factors / Q000235:genetics / Q000276:immunology; D008198:Lymph Nodes / Q000187:drug effects* / Q000276:immunology / Q000473:pathology; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis* / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015260:Neprilysin / Q000235:genetics / Q000276:immunology; D010614:Pharynx / Q000187:drug effects / Q000276:immunology / Q000473:pathology; D011241:Prednisone / Q000627:therapeutic use; D011379:Prognosis; D051560:Proto-Oncogene Proteins c-bcl-6; D000069283:Rituximab; D016019:Survival Analysis; D016896:Treatment Outcome; D014750:Vincristine / Q000627:therapeutic use; D000099218:Interferon Regulatory Factor-4
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D014408:Biomarkers, Tumor; D003520:Cyclophosphamide; D004268:DNA-Binding Proteins; D004317:Doxorubicin; D050835:Interferon Regulatory Factors; D015260:Neprilysin; D011241:Prednisone; D051560:Proto-Oncogene Proteins c-bcl-6; D000069283:Rituximab; D014750:Vincristine; D000099218:Interferon Regulatory Factor-4; C084103:BCL6 protein, human; C571759:R-CHOP protocol
keywords: Diffuse large B cell lymphoma; Extranodal involvement; GCB phenotype; Rituximab; Waldeyer's ring