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ORIGINAL ARTICLE - REAL WORLD DATA
Year : 2022  |  Volume : 5  |  Issue : 1  |  Page : 67-74

Clinicopathologic features and outcomes of diffuse large B-cell lymphoma with extranodal involvement: A retrospective analysis


1 Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India
2 Department of Radiation Oncology, All India Institute of Medical Sciences, New Delhi, India
3 Department of Laboratory Oncology, All India Institute of Medical Sciences, New Delhi, India
4 Department of Pathology, All India Institute of Medical Sciences, New Delhi, India

Correspondence Address:
Ajay Gogia
Department of Medical Oncology, IRCH, All India Institute of Medical Sciences, New Delhi - 110 029
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/crst.crst_204_21

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Background: Extranodal involvement is seen in about 40%–50% of the cases of diffuse large B-cell lymphoma (DLBCL). However, data on the clinicopathological features and outcomes of DLBCL with extranodal involvement, especially in the rituximab era, are scarce from India. Objectives: In this study, we aimed to assess the clinicopathological features and outcomes of DLBCL with extranodal involvement among Indian patients. Materials and Methods: This retrospective study was conducted on patients with DLBCL, registered in the Department of Medical Oncology of the All India Institute of Medical Sciences, Delhi, India, between January 2014 and December 2018. Patients with nodal DLBCL aged more than 18 years, with concomitant extranodal disease in any anatomical site were included. All patients were treated with multiagent chemotherapy with or without rituximab. Results: Median age of the cohort was 50 years (range, 18–86), a male-to-female ratio of 2:1. B-symptoms and bulky disease were seen in 48% and 39% patients, respectively. Bone was the most common site of extranodal involvement observed in 32% patients. Bone marrow involvement was present in 13% patients. Low-risk International Prognostic Index (IPI) was seen in 32% patients and intermediate risk IPI in 38% patients. Cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP)-based treatment was used in 80% of the patients and rituximab (R) was used in 73% of the patients. The objective response rate was 76%, with a complete response rate of 65.5%. After a median follow-up of 26 months, the 3-year progression free survival and overall survival (OS) were 65% and 82.7%, respectively. Involvement of the kidney/adrenal gland and central nervous system, high IPI score, and use of non- R-CHOP regimens were associated with a poor OS on the multivariate analysis. Conclusions: The bone is the most common site of extranodal involvement in Indian patients with DLBCL. The outcome of extranodal DLBCL depends on the primary site of disease involvement.


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