Influence of Organ‐Specific Extranodal Involvement on Survival Outcomes in Stage IV Diffuse Large B‐Cell Lymphoma
ABSTRACT Background The prognostic significance of extranodal sites in stage IV diffuse large B‐cell lymphoma (DLBCL) remains uncertain, making it challenging to select appropriate treatment strategies for individual patients. In this study, we aimed to evaluate the influence of different extranodal...
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2025-01-01
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| Online Access: | https://doi.org/10.1002/cam4.70565 |
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| author | Tong‐Yoon Kim Tae‐Jung Kim Eun Ji Han Gi June Min Sung‐Soo Park Silvia Park Jae‐Ho Yoon Sung‐Eun Lee Byung‐Sik Cho Ki‐Seong Eom Yoo‐Jin Kim Hee‐Je Kim Seok Lee Chang‐Ki Min Jong‐Wook Lee Youngwoo Jeon Seok‐Goo Cho |
| author_facet | Tong‐Yoon Kim Tae‐Jung Kim Eun Ji Han Gi June Min Sung‐Soo Park Silvia Park Jae‐Ho Yoon Sung‐Eun Lee Byung‐Sik Cho Ki‐Seong Eom Yoo‐Jin Kim Hee‐Je Kim Seok Lee Chang‐Ki Min Jong‐Wook Lee Youngwoo Jeon Seok‐Goo Cho |
| author_sort | Tong‐Yoon Kim |
| collection | DOAJ |
| description | ABSTRACT Background The prognostic significance of extranodal sites in stage IV diffuse large B‐cell lymphoma (DLBCL) remains uncertain, making it challenging to select appropriate treatment strategies for individual patients. In this study, we aimed to evaluate the influence of different extranodal sites on prognosis in young patients with stage IV DLBCL who achieved complete remission (CR) following initial chemo‐immunotherapy and to explore the potential of autologous hematopoietic stem cell transplantation (ASCT) as a consolidation treatment for specific patient subgroups. Methods We retrospectively reviewed data from 119 patients with DLBCL aged < 60 years who achieved CR after chemo‐immunotherapy between 2008 and 2020. Patient survival rates were analyzed in correlation with different extranodal sites using univariate and multivariate models. Additionally, we assessed the effect of ASCT on 5‐year progression‐free survival (PFS) and overall survival (OS) in patients with different extranodal sites involved. Study Design A retrospective bicenter study. Results Univariate analysis revealed a significant decrease in survival rates in patients with a Deauville score of 3 and those with extranodal DLBCL affecting the spleen, bone marrow, nasosinus, and liver. In multivariate analysis, only nasosinusal involvement remained a significant predictor of reduced OS. Patients with spleen involvement benefited significantly from ASCT in terms of 5‐year PFS and OS, whereas those with nasosinusal involvement did not demonstrate any survival advantage with ASCT. Conclusion Our findings highlight the influence of specific extranodal sites on the prognosis of patients with stage IV DLBCL. The data indicate a clear need for precise patient stratification based on extranodal involvement for more effective treatment planning. Notably, patients with spleen involvement appear to benefit from ASCT, suggesting that this strategy could be useful in this subgroup. Further prospective studies are needed to confirm and incorporate these findings into clinical practice. |
| format | Article |
| id | doaj-art-ffb0fdc2765c45fcb591e225d50f482f |
| institution | Kabale University |
| issn | 2045-7634 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wiley |
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| series | Cancer Medicine |
| spelling | doaj-art-ffb0fdc2765c45fcb591e225d50f482f2025-01-13T13:22:38ZengWileyCancer Medicine2045-76342025-01-01141n/an/a10.1002/cam4.70565Influence of Organ‐Specific Extranodal Involvement on Survival Outcomes in Stage IV Diffuse Large B‐Cell LymphomaTong‐Yoon Kim0Tae‐Jung Kim1Eun Ji Han2Gi June Min3Sung‐Soo Park4Silvia Park5Jae‐Ho Yoon6Sung‐Eun Lee7Byung‐Sik Cho8Ki‐Seong Eom9Yoo‐Jin Kim10Hee‐Je Kim11Seok Lee12Chang‐Ki Min13Jong‐Wook Lee14Youngwoo Jeon15Seok‐Goo Cho16Department of Hematology, Yeouido St. Mary's Hospital, College of Medicine The Catholic University of Korea Seoul KoreaDepartment of Hospital Pathology, Yeouido St. Mary's Hospital, College of Medicine The Catholic University of Korea Seoul KoreaDivision of Nuclear Medicine, Department of Radiology, Yeouido St. Mary's Hospital, College of Medicine The Catholic University of Korea Seoul KoreaLymphoma and Cell Therapy Research Center, Yeouido St. Mary's Hospital, College of Medicine The Catholic University of Korea Seoul KoreaDepartment of Hematology, Seoul St. Mary's Hospital, College of Medicine The Catholic University of Korea Seoul KoreaDepartment of Hematology, Seoul St. Mary's Hospital, College of Medicine The Catholic University of Korea Seoul KoreaDepartment of Hematology, Seoul St. Mary's Hospital, College of Medicine The Catholic University of Korea Seoul KoreaDepartment of Hematology, Seoul St. Mary's Hospital, College of Medicine The Catholic University of Korea Seoul KoreaDepartment of Hematology, Seoul St. Mary's Hospital, College of Medicine The Catholic University of Korea Seoul KoreaDepartment of Hematology, Seoul St. Mary's Hospital, College of Medicine The Catholic University of Korea Seoul KoreaDepartment of Hematology, Seoul St. Mary's Hospital, College of Medicine The Catholic University of Korea Seoul KoreaDepartment of Hematology, Seoul St. Mary's Hospital, College of Medicine The Catholic University of Korea Seoul KoreaDepartment of Hematology, Seoul St. Mary's Hospital, College of Medicine The Catholic University of Korea Seoul KoreaDepartment of Hematology, Seoul St. Mary's Hospital, College of Medicine The Catholic University of Korea Seoul KoreaDepartment of Hematology, Seoul St. Mary's Hospital, College of Medicine The Catholic University of Korea Seoul KoreaDepartment of Hematology, Yeouido St. Mary's Hospital, College of Medicine The Catholic University of Korea Seoul KoreaLymphoma and Cell Therapy Research Center, Yeouido St. Mary's Hospital, College of Medicine The Catholic University of Korea Seoul KoreaABSTRACT Background The prognostic significance of extranodal sites in stage IV diffuse large B‐cell lymphoma (DLBCL) remains uncertain, making it challenging to select appropriate treatment strategies for individual patients. In this study, we aimed to evaluate the influence of different extranodal sites on prognosis in young patients with stage IV DLBCL who achieved complete remission (CR) following initial chemo‐immunotherapy and to explore the potential of autologous hematopoietic stem cell transplantation (ASCT) as a consolidation treatment for specific patient subgroups. Methods We retrospectively reviewed data from 119 patients with DLBCL aged < 60 years who achieved CR after chemo‐immunotherapy between 2008 and 2020. Patient survival rates were analyzed in correlation with different extranodal sites using univariate and multivariate models. Additionally, we assessed the effect of ASCT on 5‐year progression‐free survival (PFS) and overall survival (OS) in patients with different extranodal sites involved. Study Design A retrospective bicenter study. Results Univariate analysis revealed a significant decrease in survival rates in patients with a Deauville score of 3 and those with extranodal DLBCL affecting the spleen, bone marrow, nasosinus, and liver. In multivariate analysis, only nasosinusal involvement remained a significant predictor of reduced OS. Patients with spleen involvement benefited significantly from ASCT in terms of 5‐year PFS and OS, whereas those with nasosinusal involvement did not demonstrate any survival advantage with ASCT. Conclusion Our findings highlight the influence of specific extranodal sites on the prognosis of patients with stage IV DLBCL. The data indicate a clear need for precise patient stratification based on extranodal involvement for more effective treatment planning. Notably, patients with spleen involvement appear to benefit from ASCT, suggesting that this strategy could be useful in this subgroup. Further prospective studies are needed to confirm and incorporate these findings into clinical practice.https://doi.org/10.1002/cam4.70565autologous hematopoietic stem cell transplantationdiffuse large B‐cell lymphomaextranodal involvementpositron emission tomography |
| spellingShingle | Tong‐Yoon Kim Tae‐Jung Kim Eun Ji Han Gi June Min Sung‐Soo Park Silvia Park Jae‐Ho Yoon Sung‐Eun Lee Byung‐Sik Cho Ki‐Seong Eom Yoo‐Jin Kim Hee‐Je Kim Seok Lee Chang‐Ki Min Jong‐Wook Lee Youngwoo Jeon Seok‐Goo Cho Influence of Organ‐Specific Extranodal Involvement on Survival Outcomes in Stage IV Diffuse Large B‐Cell Lymphoma Cancer Medicine autologous hematopoietic stem cell transplantation diffuse large B‐cell lymphoma extranodal involvement positron emission tomography |
| title | Influence of Organ‐Specific Extranodal Involvement on Survival Outcomes in Stage IV Diffuse Large B‐Cell Lymphoma |
| title_full | Influence of Organ‐Specific Extranodal Involvement on Survival Outcomes in Stage IV Diffuse Large B‐Cell Lymphoma |
| title_fullStr | Influence of Organ‐Specific Extranodal Involvement on Survival Outcomes in Stage IV Diffuse Large B‐Cell Lymphoma |
| title_full_unstemmed | Influence of Organ‐Specific Extranodal Involvement on Survival Outcomes in Stage IV Diffuse Large B‐Cell Lymphoma |
| title_short | Influence of Organ‐Specific Extranodal Involvement on Survival Outcomes in Stage IV Diffuse Large B‐Cell Lymphoma |
| title_sort | influence of organ specific extranodal involvement on survival outcomes in stage iv diffuse large b cell lymphoma |
| topic | autologous hematopoietic stem cell transplantation diffuse large B‐cell lymphoma extranodal involvement positron emission tomography |
| url | https://doi.org/10.1002/cam4.70565 |
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