Retrospective analysis of twenty-six patients with primary gastric diffuse large B cell lymphoma:the contribution of rituximab / 军事医学

ABSTRACT

Objective To analyze the clinical characteristics , diagnosis, therapy and prognosis of new diagnosed pri-mary gastric diffuse large B cell lymphoma ( PGDLBCL) and to discuss the efficacy of rituximab .Methods Between Jan 2005 and May 2012 , twenty-six new-diagnosed PGDLBCL patients were reviewed retrospectively .The clinical characteris-tics, diagnosis, therapy, results and prognostic factors were analyzed .Results There were 14 males and 12 females.Their age ranged from 25 to 82 (median, 50.1) years old.The most common symptom was stomachache .Treatment strategies were chemotherapy alone ( n=9) [ scheduled as cyclophosphamide , doxorubicin , vincristine and prednisone ( CHOP) and CHOP-like] and chemotherapy combined with rituximab (n=17), followed by radiotherapy of the stomach with or without regional nodes .All clinical and pathological features were similar between the two groups .The median follow-up time was 40 months.The overall response rate was 100%(9/9)in CHOP group, including 55.56%(5/9) CR, and 93.75%(15/16) in RCHOP group including 50%(8/16) CR (P>0.05).The total PFS and OS of 5 years were 60.3%and 74.4%respectively.The PFS in CHOP group and RCHOP group was 66.7% and 58.9%, respectively,and the OS was 66.7%and 84.6%, respectively.Although the OS of RCHOP group was much better than that of CHOP group , there was no sta-tistically significant difference.Univariate analysis showed that IPI (P<0.05) and Lugano staging (P<0.05) were inde-pendent factors of survival in patients with PGDLBCL .Conclusion Chemotherapy could be the first-line therapy of PGDL-BCL.The overall survival rate might be increased by adding rituximab to chemotherapy .The Lugano stage and IPI are im-portant prognostic factors .