Ocular Adnexal Diffuse Large B-cell LymphomaA Multicenter International Study

Helga D Munch-Petersen; Peter K Rasmussen; Sarah E Coupland; Bita Esmaeli; Paul T Finger; Gerardo F Graue; Hans E Grossniklaus; Santosh G Honavar; Jwu Jin Khong; Penny A McKelvie; Kaustubh Mulay; Jan U Prause; Elisabeth Ralfkiaer; Lene D Sjö; Matthew C Sniegowski; Geeta K Vemuganti; Steffen Heegaard

doi:10.1001/jamaophthalmol.2014.4644

Ocular Adnexal Diffuse Large B-cell LymphomaA Multicenter International Study

Helga D Munch-Petersen, Peter K Rasmussen, Sarah E Coupland, Bita Esmaeli, Paul T Finger, Gerardo F Graue, Hans E Grossniklaus, Santosh G Honavar, Jwu Jin Khong, Penny A McKelvie, Kaustubh Mulay, Jan U Prause, Elisabeth Ralfkiaer, Lene D Sjö, Matthew C Sniegowski, Geeta K Vemuganti, Steffen Heegaard

37 Citationer (Scopus)

Abstract

IMPORTANCE: The clinical features of diffuse large B-cell lymphoma (DLBCL) subtype of ocular adnexal lymphoma have not previously been evaluated in a large cohort to our knowledge.

OBJECTIVE: To investigate the clinical features of ocular adnexal DLBCL (OA-DLBCL).

DESIGN, SETTING, AND PARTICIPANTS: This retrospective international cooperative study involved 6 eye cancer centers. During 30 years, 106 patients with OA-DLBCL were identified, and 6 were excluded from the study. The median follow-up period was 52 months.

MAIN OUTCOMES AND MEASURES: Overall survival, disease-specific survival (DSS), and progression-free survival were the primary end points.

RESULTS: One hundred patients with OA-DLBCL were included in the study (median age, 70 years), of whom 54 (54.0%) were female. The following 3 groups of patients with lymphoma could be identified: primary OA-DLBCL (57.0%), OA-DLBCL and concurrent systemic lymphoma (29.0%), and ocular adnexal lymphoma relapse of previous systemic lymphoma (14.0%). Of 57 patients with primary OA-DLBCL, 53 (93.0%) had Ann Arbor stage IE disease, and 4 (7.0%) had Ann Arbor stage IIE disease. According to the TNM staging system, 43 of 57 (75.4%) had T2 tumors. Among all patients, the most frequent treatments were external beam radiation therapy with or without surgery (31.0%) and rituximab-cyclophosphamide, hydroxydaunorubicin, vincristine sulfate, prednisone (CHOP) or rituximab-CHOP-like chemotherapy with or without external beam radiation therapy (21.0%). The 5-year overall survival among the entire cohort was 36.0% (median, 3.5 years; 95% CI, 2.5-4.5 years). Relapse occurred in 43.9% (25 of 57) of patients with primary OA-DLBCL. Increasing T category of the TNM staging system was predictive of DSS (P = .04) in primary OA-DLBCL, whereas the Ann Arbor staging system was not. However, when taking all 100 patients into account, Ann Arbor stage was able to predict DSS (P = .01). Women had a longer median DSS than men (9.8 years; 95% CI, 1.9-17.7 years vs 3.3 years; 95% CI, 1.6-5.0; P = .03).

CONCLUSIONS AND RELEVANCE: Most patients with primary OA-DLBCL were seen with Ann Arbor stage IE and TNM T2 disease. The 5-year overall survival was between 2.5 and 4.5 years, which is the 95% CI around the median of 3.5 years in this cohort. Increasing T category appears to be associated with decreased DSS among patients with primary OA-DLBCL. When taking all patients into account, sex and Ann Arbor stage also seem to be DSS predictors.

Originalsprog	Engelsk
Tidsskrift	J A M A Ophthalmology
Vol/bind	133
Udgave nummer	2
Sider (fra-til)	165-73
Antal sider	9
ISSN	2168-6165
DOI	https://doi.org/10.1001/jamaophthalmol.2014.4644
Status	Udgivet - 1 feb. 2015

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10.1001/jamaophthalmol.2014.4644

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Munch-Petersen, H. D., Rasmussen, P. K., Coupland, S. E., Esmaeli, B., Finger, P. T., Graue, G. F., Grossniklaus, H. E., Honavar, S. G., Khong, J. J., McKelvie, P. A., Mulay, K., Prause, J. U., Ralfkiaer, E., Sjö, L. D., Sniegowski, M. C., Vemuganti, G. K., & Heegaard, S. (2015). Ocular Adnexal Diffuse Large B-cell LymphomaA Multicenter International Study. J A M A Ophthalmology, 133(2), 165-73. https://doi.org/10.1001/jamaophthalmol.2014.4644

Munch-Petersen, HD, Rasmussen, PK, Coupland, SE, Esmaeli, B, Finger, PT, Graue, GF, Grossniklaus, HE, Honavar, SG, Khong, JJ, McKelvie, PA, Mulay, K, Prause, JU, Ralfkiaer, E, Sjö, LD, Sniegowski, MC, Vemuganti, GK & Heegaard, S 2015, 'Ocular Adnexal Diffuse Large B-cell LymphomaA Multicenter International Study', J A M A Ophthalmology, bind 133, nr. 2, s. 165-73. https://doi.org/10.1001/jamaophthalmol.2014.4644

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title = "Ocular Adnexal Diffuse Large B-cell LymphomaA Multicenter International Study",

abstract = "IMPORTANCE: The clinical features of diffuse large B-cell lymphoma (DLBCL) subtype of ocular adnexal lymphoma have not previously been evaluated in a large cohort to our knowledge.OBJECTIVE: To investigate the clinical features of ocular adnexal DLBCL (OA-DLBCL).DESIGN, SETTING, AND PARTICIPANTS: This retrospective international cooperative study involved 6 eye cancer centers. During 30 years, 106 patients with OA-DLBCL were identified, and 6 were excluded from the study. The median follow-up period was 52 months.MAIN OUTCOMES AND MEASURES: Overall survival, disease-specific survival (DSS), and progression-free survival were the primary end points.RESULTS: One hundred patients with OA-DLBCL were included in the study (median age, 70 years), of whom 54 (54.0%) were female. The following 3 groups of patients with lymphoma could be identified: primary OA-DLBCL (57.0%), OA-DLBCL and concurrent systemic lymphoma (29.0%), and ocular adnexal lymphoma relapse of previous systemic lymphoma (14.0%). Of 57 patients with primary OA-DLBCL, 53 (93.0%) had Ann Arbor stage IE disease, and 4 (7.0%) had Ann Arbor stage IIE disease. According to the TNM staging system, 43 of 57 (75.4%) had T2 tumors. Among all patients, the most frequent treatments were external beam radiation therapy with or without surgery (31.0%) and rituximab-cyclophosphamide, hydroxydaunorubicin, vincristine sulfate, prednisone (CHOP) or rituximab-CHOP-like chemotherapy with or without external beam radiation therapy (21.0%). The 5-year overall survival among the entire cohort was 36.0% (median, 3.5 years; 95% CI, 2.5-4.5 years). Relapse occurred in 43.9% (25 of 57) of patients with primary OA-DLBCL. Increasing T category of the TNM staging system was predictive of DSS (P = .04) in primary OA-DLBCL, whereas the Ann Arbor staging system was not. However, when taking all 100 patients into account, Ann Arbor stage was able to predict DSS (P = .01). Women had a longer median DSS than men (9.8 years; 95% CI, 1.9-17.7 years vs 3.3 years; 95% CI, 1.6-5.0; P = .03).CONCLUSIONS AND RELEVANCE: Most patients with primary OA-DLBCL were seen with Ann Arbor stage IE and TNM T2 disease. The 5-year overall survival was between 2.5 and 4.5 years, which is the 95% CI around the median of 3.5 years in this cohort. Increasing T category appears to be associated with decreased DSS among patients with primary OA-DLBCL. When taking all patients into account, sex and Ann Arbor stage also seem to be DSS predictors.",

keywords = "Adolescent, Adult, Aged, Aged, 80 and over, Biopsy, Child, Child, Preschool, Combined Modality Therapy, Diagnosis, Differential, Disease-Free Survival, Eye Neoplasms, Female, Follow-Up Studies, Global Health, Humans, Lymphoma, Large B-Cell, Diffuse, Male, Middle Aged, Neoplasm Staging, Prognosis, Retrospective Studies, Survival Rate, Young Adult",

author = "Munch-Petersen, {Helga D} and Rasmussen, {Peter K} and Coupland, {Sarah E} and Bita Esmaeli and Finger, {Paul T} and Graue, {Gerardo F} and Grossniklaus, {Hans E} and Honavar, {Santosh G} and Khong, {Jwu Jin} and McKelvie, {Penny A} and Kaustubh Mulay and Prause, {Jan U} and Elisabeth Ralfkiaer and Sj{\"o}, {Lene D} and Sniegowski, {Matthew C} and Vemuganti, {Geeta K} and Steffen Heegaard",

year = "2015",

month = feb,

day = "1",

doi = "10.1001/jamaophthalmol.2014.4644",

language = "English",

volume = "133",

pages = "165--73",

journal = "JAMA Ophthalmology",

issn = "2168-6165",

publisher = "The JAMA Network",

number = "2",

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TY - JOUR

T1 - Ocular Adnexal Diffuse Large B-cell LymphomaA Multicenter International Study

AU - Munch-Petersen, Helga D

AU - Rasmussen, Peter K

AU - Coupland, Sarah E

AU - Esmaeli, Bita

AU - Finger, Paul T

AU - Graue, Gerardo F

AU - Grossniklaus, Hans E

AU - Honavar, Santosh G

AU - Khong, Jwu Jin

AU - McKelvie, Penny A

AU - Mulay, Kaustubh

AU - Prause, Jan U

AU - Ralfkiaer, Elisabeth

AU - Sjö, Lene D

AU - Sniegowski, Matthew C

AU - Vemuganti, Geeta K

AU - Heegaard, Steffen

PY - 2015/2/1

Y1 - 2015/2/1

N2 - IMPORTANCE: The clinical features of diffuse large B-cell lymphoma (DLBCL) subtype of ocular adnexal lymphoma have not previously been evaluated in a large cohort to our knowledge.OBJECTIVE: To investigate the clinical features of ocular adnexal DLBCL (OA-DLBCL).DESIGN, SETTING, AND PARTICIPANTS: This retrospective international cooperative study involved 6 eye cancer centers. During 30 years, 106 patients with OA-DLBCL were identified, and 6 were excluded from the study. The median follow-up period was 52 months.MAIN OUTCOMES AND MEASURES: Overall survival, disease-specific survival (DSS), and progression-free survival were the primary end points.RESULTS: One hundred patients with OA-DLBCL were included in the study (median age, 70 years), of whom 54 (54.0%) were female. The following 3 groups of patients with lymphoma could be identified: primary OA-DLBCL (57.0%), OA-DLBCL and concurrent systemic lymphoma (29.0%), and ocular adnexal lymphoma relapse of previous systemic lymphoma (14.0%). Of 57 patients with primary OA-DLBCL, 53 (93.0%) had Ann Arbor stage IE disease, and 4 (7.0%) had Ann Arbor stage IIE disease. According to the TNM staging system, 43 of 57 (75.4%) had T2 tumors. Among all patients, the most frequent treatments were external beam radiation therapy with or without surgery (31.0%) and rituximab-cyclophosphamide, hydroxydaunorubicin, vincristine sulfate, prednisone (CHOP) or rituximab-CHOP-like chemotherapy with or without external beam radiation therapy (21.0%). The 5-year overall survival among the entire cohort was 36.0% (median, 3.5 years; 95% CI, 2.5-4.5 years). Relapse occurred in 43.9% (25 of 57) of patients with primary OA-DLBCL. Increasing T category of the TNM staging system was predictive of DSS (P = .04) in primary OA-DLBCL, whereas the Ann Arbor staging system was not. However, when taking all 100 patients into account, Ann Arbor stage was able to predict DSS (P = .01). Women had a longer median DSS than men (9.8 years; 95% CI, 1.9-17.7 years vs 3.3 years; 95% CI, 1.6-5.0; P = .03).CONCLUSIONS AND RELEVANCE: Most patients with primary OA-DLBCL were seen with Ann Arbor stage IE and TNM T2 disease. The 5-year overall survival was between 2.5 and 4.5 years, which is the 95% CI around the median of 3.5 years in this cohort. Increasing T category appears to be associated with decreased DSS among patients with primary OA-DLBCL. When taking all patients into account, sex and Ann Arbor stage also seem to be DSS predictors.

AB - IMPORTANCE: The clinical features of diffuse large B-cell lymphoma (DLBCL) subtype of ocular adnexal lymphoma have not previously been evaluated in a large cohort to our knowledge.OBJECTIVE: To investigate the clinical features of ocular adnexal DLBCL (OA-DLBCL).DESIGN, SETTING, AND PARTICIPANTS: This retrospective international cooperative study involved 6 eye cancer centers. During 30 years, 106 patients with OA-DLBCL were identified, and 6 were excluded from the study. The median follow-up period was 52 months.MAIN OUTCOMES AND MEASURES: Overall survival, disease-specific survival (DSS), and progression-free survival were the primary end points.RESULTS: One hundred patients with OA-DLBCL were included in the study (median age, 70 years), of whom 54 (54.0%) were female. The following 3 groups of patients with lymphoma could be identified: primary OA-DLBCL (57.0%), OA-DLBCL and concurrent systemic lymphoma (29.0%), and ocular adnexal lymphoma relapse of previous systemic lymphoma (14.0%). Of 57 patients with primary OA-DLBCL, 53 (93.0%) had Ann Arbor stage IE disease, and 4 (7.0%) had Ann Arbor stage IIE disease. According to the TNM staging system, 43 of 57 (75.4%) had T2 tumors. Among all patients, the most frequent treatments were external beam radiation therapy with or without surgery (31.0%) and rituximab-cyclophosphamide, hydroxydaunorubicin, vincristine sulfate, prednisone (CHOP) or rituximab-CHOP-like chemotherapy with or without external beam radiation therapy (21.0%). The 5-year overall survival among the entire cohort was 36.0% (median, 3.5 years; 95% CI, 2.5-4.5 years). Relapse occurred in 43.9% (25 of 57) of patients with primary OA-DLBCL. Increasing T category of the TNM staging system was predictive of DSS (P = .04) in primary OA-DLBCL, whereas the Ann Arbor staging system was not. However, when taking all 100 patients into account, Ann Arbor stage was able to predict DSS (P = .01). Women had a longer median DSS than men (9.8 years; 95% CI, 1.9-17.7 years vs 3.3 years; 95% CI, 1.6-5.0; P = .03).CONCLUSIONS AND RELEVANCE: Most patients with primary OA-DLBCL were seen with Ann Arbor stage IE and TNM T2 disease. The 5-year overall survival was between 2.5 and 4.5 years, which is the 95% CI around the median of 3.5 years in this cohort. Increasing T category appears to be associated with decreased DSS among patients with primary OA-DLBCL. When taking all patients into account, sex and Ann Arbor stage also seem to be DSS predictors.

KW - Adolescent

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Biopsy

KW - Child

KW - Child, Preschool

KW - Combined Modality Therapy

KW - Diagnosis, Differential

KW - Disease-Free Survival

KW - Eye Neoplasms

KW - Female

KW - Follow-Up Studies

KW - Global Health

KW - Humans

KW - Lymphoma, Large B-Cell, Diffuse

KW - Male

KW - Middle Aged

KW - Neoplasm Staging

KW - Prognosis

KW - Retrospective Studies

KW - Survival Rate

KW - Young Adult

U2 - 10.1001/jamaophthalmol.2014.4644

DO - 10.1001/jamaophthalmol.2014.4644

M3 - Journal article

C2 - 25393033

SN - 2168-6165

VL - 133

SP - 165

EP - 173

JO - JAMA Ophthalmology

JF - JAMA Ophthalmology

IS - 2

ER -

Ocular Adnexal Diffuse Large B-cell LymphomaA Multicenter International Study

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