机构：[1]Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China[2]Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Lymphoma, Peking University Cancer Hospital andInstitute, Beijing, China[3]Department of Medical Oncology, The Second Hospital of Dalian Medical University, Dalian, China[4]Department of Hematology, Cancer Hospital of Shanxi Province, Taiyuan, China[5]Department of Hematology, The First Hospital of Jilin University, Jilin, China[6]Department of Medical Oncology, National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of MedicalSciences and Peking Union Medical College, Beijing, China[7]Department of Hematology, Xijing Hospital, The Fourth Military Medical University, Xi’an, China[8]Department of Medical Oncology, Liaoning Cancer Hospital and Institute, Shenyang, China[9]Department of Medical Oncology, Key Laboratory of Cancer Prevention and Therapy, National Clinical Research Center of Cancer, Tianjin Medical UniversityCancer Institute and Hospital, Tianjin, China[10]Department of Hematology, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China河北医科大学第四医院[11]Department of Medical Oncology, 307 Hospital of Chinese People’s Liberation Army, Beijing, China[12]Department of Medical Oncology, Jilin Cancer Hospital, Changchun, China[13]Department of Medical Oncology, General Hospital of Ningxia Medical University, Yinchuan, China[14]Department of Hematology, Peking University First Hospital, Beijing, China[15]Department of Medical Oncology, Xinjiang Cancer Hospital, Wulumuqi, China[16]Department of Hematology, The General Hospital of Chinese People’s Liberation Army, Beijing, China[17]Department of Medical Oncology, The People’s Hospital of Tangshan City, Tangshan, China[18]Department of Medical Oncology, Baotou Cancer Hospital, Baotou, China[19]Department of Hematology, The Third Hospital of Harbin Medical University, Haerbin, China[20]Department of Hematology, Beijing Tongren Hospital, Capital Medical University, Beijing, China临床科室血液内科首都医科大学附属北京同仁医院首都医科大学附属同仁医院[21]Illinois Institute of Technology, Chicago, Illinois[22]Department of Hematology, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China河南省肿瘤医院
Primary breast diffuse large B-cell lymphoma (PB-DLBCL) is a rare subtype of DLBCL with limited data on patterns of failure. This multicenter study aimed to define the optimum treatment strategy and patterns of failure for PB-DLBCL patients. We retrospectively reviewed data on 108 PB-DLBCL patients from 21 Chinese medical centers. Only patients with localized disease (involvement of breast and localized lymph nodes) were included. After a median follow-up of 3.2 years, 32% of patients developed progression or relapse. A continuous pattern of relapse was observed, characterized by frequent late relapses in the contralateral breast and central nervous system (CNS). Although rituximab significantly reduced the overall cumulative risk of progression or relapse (5-year cumulative risk 57% vs 24%, P = .029), it had limited effect on the reduction of breast relapse (P = .46). Consolidative radiotherapy significantly decreased the risk of breast relapse, even in the subgroup of patients treated with rituximab (5-year cumulative risk 21.2% vs 0%, P = .012). A continuous risk of CNS progression or relapse up to 8.2 years from diagnosis was observed (10-year cumulative risk 28.3%), with a median time to CNS relapse of 3.1 years. Neither rituximab nor prophylactic intrathecal chemotherapy significantly decreased the risk of CNS relapse. In summary, our study indicates that PB-DLBCL has a continuous pattern of relapse, especially with frequent late relapses in the CNS and contralateral breast. Rituximab and RT confer complementary benefit in the reduction of relapse. However, neither the addition of rituximab nor prophylactic intrathecal chemotherapy could effectively prevent CNS relapse for PB-DLBCL patients.
基金：
Cancer Institute and Hospital, Chinese
Academy of Medical Sciences
第一作者机构：[1]Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
共同第一作者：
通讯作者：
通讯机构：[6]Department of Medical Oncology, National Cancer Center/ National Clinical Research Center for Cancer/ Cancer Hospital, Chinese Academy of MedicalSciences and Peking Union Medical College, Beijing, China[22]Department of Hematology, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China[*1]Department of Medical Oncology, Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.[*2]Department of Hematology, Affiliated Cancer Hospital of Zhengzhou University, Zhengzhou, China.
推荐引用方式(GB/T 7714)：
Shaoxuan Hu,Yuqin Song,Xiuhua Sun,et al.Primary breast diffuse large B-cell lymphoma in the rituximab era: Therapeutic strategies and patterns of failure[J].CANCER SCIENCE.2018,109(12):3943-3952.doi:10.1111/cas.13828.
APA：
Shaoxuan Hu,Yuqin Song,Xiuhua Sun,Liping Su,Wei Zhang...&Xiaohui He.(2018).Primary breast diffuse large B-cell lymphoma in the rituximab era: Therapeutic strategies and patterns of failure.CANCER SCIENCE,109,(12)
MLA：
Shaoxuan Hu,et al."Primary breast diffuse large B-cell lymphoma in the rituximab era: Therapeutic strategies and patterns of failure".CANCER SCIENCE 109..12(2018):3943-3952
