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Biological Features and Prognostic Impact of Bone Marrow Infiltration in Patients with Diffuse Large B-cell Lymphoma

The biology and clinical impact of bone marrow (BM) infiltration in patients with diffuse large B-cell lymphoma (DLBCL) remains unclear in the rituximab era. We retrospectively analyzed 232 patients diagnosed with DLBCL at our center between 1999 and 2014. Concordant-presence of large cells similar...

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Autores principales: Alonso-Álvarez, Sara, Alcoceba, Miguel, García-Álvarez, María, Blanco, Oscar, Rodríguez, Marta, Baile, Mónica, Caballero, Juan Carlos, Dávila, Julio, Vidriales, María Belén, Esteban, Carmen, Arias, Piedad, Díaz, Luis G., Tamayo, Pilar, Caballero, María Dolores, Gutiérrez, Norma C., González, Marcos, Martín, Alejandro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7072385/
https://www.ncbi.nlm.nih.gov/pubmed/32085520
http://dx.doi.org/10.3390/cancers12020474
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author Alonso-Álvarez, Sara
Alcoceba, Miguel
García-Álvarez, María
Blanco, Oscar
Rodríguez, Marta
Baile, Mónica
Caballero, Juan Carlos
Dávila, Julio
Vidriales, María Belén
Esteban, Carmen
Arias, Piedad
Díaz, Luis G.
Tamayo, Pilar
Caballero, María Dolores
Gutiérrez, Norma C.
González, Marcos
Martín, Alejandro
author_facet Alonso-Álvarez, Sara
Alcoceba, Miguel
García-Álvarez, María
Blanco, Oscar
Rodríguez, Marta
Baile, Mónica
Caballero, Juan Carlos
Dávila, Julio
Vidriales, María Belén
Esteban, Carmen
Arias, Piedad
Díaz, Luis G.
Tamayo, Pilar
Caballero, María Dolores
Gutiérrez, Norma C.
González, Marcos
Martín, Alejandro
author_sort Alonso-Álvarez, Sara
collection PubMed
description The biology and clinical impact of bone marrow (BM) infiltration in patients with diffuse large B-cell lymphoma (DLBCL) remains unclear in the rituximab era. We retrospectively analyzed 232 patients diagnosed with DLBCL at our center between 1999 and 2014. Concordant-presence of large cells similar to those of the lymph node biopsy- and discordant-infiltration by small cells forming lymphoid aggregates, lacking cytological atypia-BM infiltration was defined by histological criteria and further characterized by flow cytometry (FCM). Cell of origin (COO) was determined using Hans’ algorithm. For the clonal relationship between tumor and discordant BM, the VDJH rearrangement was analyzed. Survival analyses were restricted to 189 patients treated with rituximab and chemotherapy. Thirty-six (16%) had concordant, and 37 (16%) discordant BM infiltration. FCM described different indolent lymphomas among discordant cases, clonally related with DLBCL in 10/13 available samples. Median follow-up was 58 months. 5-year-progression-free survival (PFS) for non-infiltrated, discordant and concordant groups was 68%, 65% and 30%, respectively (p < 0.001). Combining COO and BM infiltration, patients with discordant BM and non-germinal center B-cell COO also had decreased 5-year-PFS (41.9%). In multivariate analysis, concordant BM had an independent effect on PFS (HR 2.5, p = 0.01). Five-year cumulative incidence of central nervous system (CNS) relapse was 21%, 4% and 1% in concordant, discordant and non-infiltrated groups, respectively (p < 0.001). In conclusion, concordant BM infiltration represents a subset with poor prognosis, whereas the prognostic impact of discordant BM infiltration could be limited to non-CGB cases.
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spelling pubmed-70723852020-03-19 Biological Features and Prognostic Impact of Bone Marrow Infiltration in Patients with Diffuse Large B-cell Lymphoma Alonso-Álvarez, Sara Alcoceba, Miguel García-Álvarez, María Blanco, Oscar Rodríguez, Marta Baile, Mónica Caballero, Juan Carlos Dávila, Julio Vidriales, María Belén Esteban, Carmen Arias, Piedad Díaz, Luis G. Tamayo, Pilar Caballero, María Dolores Gutiérrez, Norma C. González, Marcos Martín, Alejandro Cancers (Basel) Article The biology and clinical impact of bone marrow (BM) infiltration in patients with diffuse large B-cell lymphoma (DLBCL) remains unclear in the rituximab era. We retrospectively analyzed 232 patients diagnosed with DLBCL at our center between 1999 and 2014. Concordant-presence of large cells similar to those of the lymph node biopsy- and discordant-infiltration by small cells forming lymphoid aggregates, lacking cytological atypia-BM infiltration was defined by histological criteria and further characterized by flow cytometry (FCM). Cell of origin (COO) was determined using Hans’ algorithm. For the clonal relationship between tumor and discordant BM, the VDJH rearrangement was analyzed. Survival analyses were restricted to 189 patients treated with rituximab and chemotherapy. Thirty-six (16%) had concordant, and 37 (16%) discordant BM infiltration. FCM described different indolent lymphomas among discordant cases, clonally related with DLBCL in 10/13 available samples. Median follow-up was 58 months. 5-year-progression-free survival (PFS) for non-infiltrated, discordant and concordant groups was 68%, 65% and 30%, respectively (p < 0.001). Combining COO and BM infiltration, patients with discordant BM and non-germinal center B-cell COO also had decreased 5-year-PFS (41.9%). In multivariate analysis, concordant BM had an independent effect on PFS (HR 2.5, p = 0.01). Five-year cumulative incidence of central nervous system (CNS) relapse was 21%, 4% and 1% in concordant, discordant and non-infiltrated groups, respectively (p < 0.001). In conclusion, concordant BM infiltration represents a subset with poor prognosis, whereas the prognostic impact of discordant BM infiltration could be limited to non-CGB cases. MDPI 2020-02-18 /pmc/articles/PMC7072385/ /pubmed/32085520 http://dx.doi.org/10.3390/cancers12020474 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Alonso-Álvarez, Sara
Alcoceba, Miguel
García-Álvarez, María
Blanco, Oscar
Rodríguez, Marta
Baile, Mónica
Caballero, Juan Carlos
Dávila, Julio
Vidriales, María Belén
Esteban, Carmen
Arias, Piedad
Díaz, Luis G.
Tamayo, Pilar
Caballero, María Dolores
Gutiérrez, Norma C.
González, Marcos
Martín, Alejandro
Biological Features and Prognostic Impact of Bone Marrow Infiltration in Patients with Diffuse Large B-cell Lymphoma
title Biological Features and Prognostic Impact of Bone Marrow Infiltration in Patients with Diffuse Large B-cell Lymphoma
title_full Biological Features and Prognostic Impact of Bone Marrow Infiltration in Patients with Diffuse Large B-cell Lymphoma
title_fullStr Biological Features and Prognostic Impact of Bone Marrow Infiltration in Patients with Diffuse Large B-cell Lymphoma
title_full_unstemmed Biological Features and Prognostic Impact of Bone Marrow Infiltration in Patients with Diffuse Large B-cell Lymphoma
title_short Biological Features and Prognostic Impact of Bone Marrow Infiltration in Patients with Diffuse Large B-cell Lymphoma
title_sort biological features and prognostic impact of bone marrow infiltration in patients with diffuse large b-cell lymphoma
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7072385/
https://www.ncbi.nlm.nih.gov/pubmed/32085520
http://dx.doi.org/10.3390/cancers12020474
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