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The influence of immunodeficiency, disease features, and patient characteristics on survival in plasmablastic lymphoma.
Di Ciaccio, Pietro R; Polizzotto, Mark N; Cwynarski, Kate; Gerrie, Alina S; Burton, Catherine; Bower, Mark; Kuruvilla, John; Montoto, Silvia; McKay, Pam; Fox, Christopher P; Milliken, Samuel; Jiamsakul, Awachana; Osborne, Wendy; Collins, Graham P; Manos, Kate; Linton, Kim M; Iyengar, Sunil; Kassam, Shireen; Limei, Michelle Poon; Kliman, David; Wong Doo, Nicole; Watson, Anne-Marie; Fedele, Pasquale; Yannakou, Costas K; Hunt, Stewart; Ku, Matthew; Sehn, Laurie H; Smith, Alexandra; Renshaw, Hanna; Maxwell, Alice; Liu, Qin; Dhairyawan, Rageshri; Ferguson, Graeme; Pickard, Keir; Painter, Daniel; Thakrar, Nisha; Song, Kevin W; Hamad, Nada.
Afiliação
  • Di Ciaccio PR; Department of Haematology, The Canberra Hospital, Garran, ACT, Australia.
  • Polizzotto MN; College of Health and Medicine, Australian National University, Canberra, ACT, Australia.
  • Cwynarski K; Department of Haematology, The Canberra Hospital, Garran, ACT, Australia.
  • Gerrie AS; John Curtin School of Medical Research, Australian National University, Canberra, ACT, Australia.
  • Burton C; Department of Haematology, University College Hospital, London, United Kingdom.
  • Bower M; Centre for Lymphoid Cancer and Division of Medical Oncology, BC Cancer, University of British Columbia, Vancouver, BC, Canada.
  • Kuruvilla J; Department of Haematology, St James University Hospital, Leeds, United Kingdom.
  • Montoto S; National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, United Kingdom.
  • McKay P; Division of Oncology and Haematology, Princess Margaret Cancer Centre, The Princess Margaret Hospital, Toronto, ON, Canada.
  • Fox CP; Department of Haemato-oncology, St Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom.
  • Milliken S; Beatson West of Scotland Cancer Centre, Glasgow, United Kingdom.
  • Jiamsakul A; University Hospitals NHS Trust, Nottingham, United Kingdom.
  • Osborne W; School of Medicine, University of Nottingham, Nottingham, United Kingdom.
  • Collins GP; Department of Haematology, St Vincent's Hospital, Sydney, NSW, Australia.
  • Manos K; The Kirby Institute, University of New South Wales, Sydney, NSW, Australia.
  • Linton KM; Department of Haematology, Freeman Hospital, Newcastle upon Tyne NHS Foundation Trust, Newcastle-upon-Tyne, United Kingdom.
  • Iyengar S; Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom.
  • Kassam S; Department of Haematology, Flinders Medical Centre, Adelaide, SA, Australia.
  • Limei MP; The Christie Hospital NHS Foundation Trust, Manchester, United Kingdom.
  • Kliman D; Manchester Cancer Research Centre, University of Manchester, Manchester, United Kingdom.
  • Wong Doo N; Manchester Academic Health Science Centre, Manchester, United Kingdom.
  • Watson AM; The Royal Marsden NHS Foundation Trust, London, United Kingdom.
  • Fedele P; King's College Hospital, London, United Kingdom.
  • Yannakou CK; Department of Haematology, National University Hospital, Singapore.
  • Hunt S; Department of Haematology, Royal North Shore Hospital, Sydney, NSW, Australia.
  • Ku M; Department of Haematology, Concord Repatriation General Hospital, Sydney, NSW, Australia.
  • Sehn LH; Faculty of Medicine, University of Sydney, Sydney, NSW, Australia.
  • Smith A; Department of Haematology, Liverpool Hospital, Sydney, NSW, Australia.
  • Renshaw H; School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia.
  • Maxwell A; Haematology Department, Monash Health, Clayton, VIC, Australia.
  • Liu Q; Department of Molecular Oncology and Cancer Immunology, Epworth Freemasons Hospital, Epworth HealthCare, Melbourne, Victoria, Australia.
  • Dhairyawan R; Department of Haematology, Royal Brisbane and Women's Hospital, Brisbane, QLD, Australia.
  • Ferguson G; Department of Haematology, St Vincent's Hospital, Melbourne, VIC, Australia.
  • Pickard K; Centre for Lymphoid Cancer and Division of Medical Oncology, BC Cancer, University of British Columbia, Vancouver, BC, Canada.
  • Painter D; Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, United Kingdom.
  • Thakrar N; Department of Haematology, University College Hospital, London, United Kingdom.
  • Song KW; National Centre for HIV Malignancy, Chelsea and Westminster Hospital, London, United Kingdom.
  • Hamad N; Division of Oncology and Haematology, Princess Margaret Cancer Centre, The Princess Margaret Hospital, Toronto, ON, Canada.
Blood ; 143(2): 152-165, 2024 Jan 11.
Article em En | MEDLINE | ID: mdl-37832030
ABSTRACT: Plasmablastic lymphoma (PBL) is a rare and aggressive non-Hodgkin lymphoma associated with immunodeficiency, characterized by uncertain treatment approaches and an unfavorable prognosis. We conducted a multicenter, international, retrospective cohort study, aiming to characterize the clinical features, risk factors, and outcomes of patients with PBL. Data were collected from 22 institutions across 4 countries regarding patients diagnosed with PBL between 1 January 1999 and 31 December 2020. Survival risk factors were analyzed using both univariate and multivariate regression models. Overall survival (OS) was calculated using Kaplan-Meier statistics. First-line treatment regimens were stratified into standard- and higher-intensity regimens, and based on whether they incorporated a proteasome inhibitor (PI). A total of 281 patients (median age, 55 years) were included. Immunodeficiency of any kind was identified in 144 patients (51%), and 99 patients (35%) had HIV-positive results. The 5-year OS for the entire cohort was 36% (95% confidence interval, 30%-42%). In multivariate analysis, inferior OS was associated with Epstein-Barr virus-negative lymphoma, poor performance status, advanced stage, and bone marrow involvement. In an independent univariate analysis, the international prognostic index was associated with OS outcomes. Neither immunosuppression nor HIV infection, specifically, influenced OS. Among patients treated with curative intent (n = 234), the overall response rate was 72%. Neither the intensity of the treatment regimen nor the inclusion of PIs in first-line therapy was associated with OS. In this large retrospective study of patients with PBL, we identified novel risk factors for survival. PBL remains a challenging disease with poor long-term outcomes.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Infecções por HIV / Infecções por Vírus Epstein-Barr / Linfoma Plasmablástico Limite: Humans / Middle aged Idioma: En Ano de publicação: 2024 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Infecções por HIV / Infecções por Vírus Epstein-Barr / Linfoma Plasmablástico Limite: Humans / Middle aged Idioma: En Ano de publicação: 2024 Tipo de documento: Article