Primary mediastinal large B-cell lymphoma: A clinicopathologic study of 43 patients from the Nebraska lymphoma study group

Ashraf A. Abou-Elella, Dennis D. Weisenburger, Julie Marie Vose, Jeffrey P. Kollath, James C. Lynch, Martin A. Bast, Philip Jay Bierman, Timothy Charles Greiner, Wing C. Chan, James Olen Armitage

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Abstract

Purpose: To investigate whether primary mediastinal large B-cell lymphoma (PMLBL) is a distinct clinicopathologic entity with a more aggressive course than other diffuse large B-cell lymphomas (DLBL). Materials and Methods: All patients with CD20-positive DLBL who presented with a mediastinal mass measuring at least 5.0 cm and were treated with curative intent were identified. A control group of 352 patients with nonmediastinal DLBL was selected for comparison. Results: The 43 patients with PMLBL had a male to female ratio of 20:23 and a median age of 42 years. Stage I/II disease was present in 58% of the patients, with only 9% having bone marrow involvement. A complete remission was achieved in 63% of the patients, and the 5-year overall and failure-free survivals were 46% and 38%, respectively. Among the clinical variables, an elevated serum lactate dehydrogenase level, a low performance score, more than one extranodal site, and an intermediate or high International Prognostic Index score were predictive of poor survival. When compared with the DLBL group, a younger median age was the only clinical feature that was significantly different in the PMLBL group. Conclusion: The clinical features of PMLBL do not appear to be significantly different from those of nonmediastinal DLBL. Although the younger age of onset, slight female predominance, mediastinal location, and size of the mass may justify the recognition of PMLBL as a clinical syndrome, additional evidence is needed to define it as a distinct disease entity.

Original languageEnglish (US)
Pages (from-to)784-790
Number of pages7
JournalJournal of Clinical Oncology
Volume17
Issue number3
StatePublished - Mar 1 1999

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Lymphoma, Large B-Cell, Diffuse
B-Cell Lymphoma
Lymphoma
Survival
Age of Onset
L-Lactate Dehydrogenase
Bone Marrow
Control Groups
Serum

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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Primary mediastinal large B-cell lymphoma : A clinicopathologic study of 43 patients from the Nebraska lymphoma study group. / Abou-Elella, Ashraf A.; Weisenburger, Dennis D.; Vose, Julie Marie; Kollath, Jeffrey P.; Lynch, James C.; Bast, Martin A.; Bierman, Philip Jay; Greiner, Timothy Charles; Chan, Wing C.; Armitage, James Olen.

In: Journal of Clinical Oncology, Vol. 17, No. 3, 01.03.1999, p. 784-790.

Research output: Contribution to journalArticle

Abou-Elella, Ashraf A. ; Weisenburger, Dennis D. ; Vose, Julie Marie ; Kollath, Jeffrey P. ; Lynch, James C. ; Bast, Martin A. ; Bierman, Philip Jay ; Greiner, Timothy Charles ; Chan, Wing C. ; Armitage, James Olen. / Primary mediastinal large B-cell lymphoma : A clinicopathologic study of 43 patients from the Nebraska lymphoma study group. In: Journal of Clinical Oncology. 1999 ; Vol. 17, No. 3. pp. 784-790.
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abstract = "Purpose: To investigate whether primary mediastinal large B-cell lymphoma (PMLBL) is a distinct clinicopathologic entity with a more aggressive course than other diffuse large B-cell lymphomas (DLBL). Materials and Methods: All patients with CD20-positive DLBL who presented with a mediastinal mass measuring at least 5.0 cm and were treated with curative intent were identified. A control group of 352 patients with nonmediastinal DLBL was selected for comparison. Results: The 43 patients with PMLBL had a male to female ratio of 20:23 and a median age of 42 years. Stage I/II disease was present in 58{\%} of the patients, with only 9{\%} having bone marrow involvement. A complete remission was achieved in 63{\%} of the patients, and the 5-year overall and failure-free survivals were 46{\%} and 38{\%}, respectively. Among the clinical variables, an elevated serum lactate dehydrogenase level, a low performance score, more than one extranodal site, and an intermediate or high International Prognostic Index score were predictive of poor survival. When compared with the DLBL group, a younger median age was the only clinical feature that was significantly different in the PMLBL group. Conclusion: The clinical features of PMLBL do not appear to be significantly different from those of nonmediastinal DLBL. Although the younger age of onset, slight female predominance, mediastinal location, and size of the mass may justify the recognition of PMLBL as a clinical syndrome, additional evidence is needed to define it as a distinct disease entity.",
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AU - Weisenburger, Dennis D.

AU - Vose, Julie Marie

AU - Kollath, Jeffrey P.

AU - Lynch, James C.

AU - Bast, Martin A.

AU - Bierman, Philip Jay

AU - Greiner, Timothy Charles

AU - Chan, Wing C.

AU - Armitage, James Olen

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N2 - Purpose: To investigate whether primary mediastinal large B-cell lymphoma (PMLBL) is a distinct clinicopathologic entity with a more aggressive course than other diffuse large B-cell lymphomas (DLBL). Materials and Methods: All patients with CD20-positive DLBL who presented with a mediastinal mass measuring at least 5.0 cm and were treated with curative intent were identified. A control group of 352 patients with nonmediastinal DLBL was selected for comparison. Results: The 43 patients with PMLBL had a male to female ratio of 20:23 and a median age of 42 years. Stage I/II disease was present in 58% of the patients, with only 9% having bone marrow involvement. A complete remission was achieved in 63% of the patients, and the 5-year overall and failure-free survivals were 46% and 38%, respectively. Among the clinical variables, an elevated serum lactate dehydrogenase level, a low performance score, more than one extranodal site, and an intermediate or high International Prognostic Index score were predictive of poor survival. When compared with the DLBL group, a younger median age was the only clinical feature that was significantly different in the PMLBL group. Conclusion: The clinical features of PMLBL do not appear to be significantly different from those of nonmediastinal DLBL. Although the younger age of onset, slight female predominance, mediastinal location, and size of the mass may justify the recognition of PMLBL as a clinical syndrome, additional evidence is needed to define it as a distinct disease entity.

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