Primary mediastinal large B-cell lymphoma: a single-center experience in Korea

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¾ÈÈñÁØ(Ahn Heui-June) - University of Ulsan College of Medicine Gangneung Asan Medical Center Department of Internal Medicine
À±´öÇö(Yoon Dok-Hyun) - University of Ulsan College of Medicine Department of Oncology
±è½Å(Kim Shin) - University of Ulsan College of Medicine Department of Oncology
À̰æ¹Î(Lee Kyoung-Min) - University of Ulsan College of Medicine Department of Oncology
°­ÀºÈñ(Kang Eun-Hee) - University of Ulsan College of Medicine Department of Oncology
ÇãÁÖ·É(Huh Joo-Ryung) - University of Ulsan College of Medicine Department of Pathology
¹ÚÂù½Ä(Park Chan-Sik) - University of Ulsan College of Medicine Department of Pathology
(Suh Cheol-Won) - University of Ulsan College of Medicine Department of Oncology

Abstract

Background: Primary mediastinal large B-cell lymphoma (PMBL) is a distinct subtype of non-Hodgkin lymphoma, which has no consensus for its ideal treatment or prognosis.

Methods: We reviewed the clinicopathologic features and clinical outcomes of 25 PMBL cases diag-nosed at a single institution between 1993 and 2009 and compared them with 588 cases of non-mediastinal, diffuse large B-cell lymphoma (DLBCL, control group) diagnosed dur-ing the same period.

Results: Thirteen (52.0%) PMBL patients had Ann Arbor stage III or IV disease, and 10 (40.0%) had B symptoms. Thirteen (52%) PMBL patients were classified as high-inter-mediate/high-risk according to the International Prognostic Index. There was a significant prevalence of young (median: 31 years; range, 15?78 years; P£¼0.001), female (68%; P=0.014) patients in the PMBL group compared to the control group (median: 56 years; range, 15?85 years; 43.2% female). Bulky disease and elevated levels of lactate de-hydrogenase (LDH) were more frequent in the PMBL group (P£¼0.001 and P=0.003, re-spectively). Nineteen (76%) PBML patients achieved complete remission, and 18 were alive at the last follow-up (median: 43 months; range, 1?92 months). There was no differ-ence in the 3-year, overall survival rate (72%, 95% confidence interval [CI]: 54.0?83.0 versus 70.1%, 95% CI, 109.0?126.0; P=0.686) between PMBL and control patients, respectively.

Conclusion: Compared to patients with non-mediastinal DLBCL, Korean patients with PMBL are pre-dominantly young women with bulky disease and high LDH levels but with no significant difference in survival.

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Lymphoma, B cell, PMBL, Prognosis, Treatment
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