MANAGEMENT OF PRIMARY HEPATIC NON-HODGKIN?S LYMPHOMA (PHL)
(Abstract release date: 05/19/16)
EHA Library. Cerchione C. 06/09/16; 134629; PB1729
Dr. Claudio Cerchione
Contributions
Contributions
Abstract
Abstract: PB1729
Type: Publication Only
Background
Primary Hepatic (PHL) is a rare form of NHL, characterized by the exclusive involvement of the liver at the moment of the diagnosis, whereas other localizations, such as lymph nodes, spleen, bone marrow and peripheral blood, or other tissues are free of disease at least for 6 months after diagnosis. Even if its occurrence is rare, PHL should enter in the differential diagnosis of every space-occupying liver lesion, in particular if they are present in concomitance with normal levels of AFP and/or CEA and in absence of liver cirrhosis.
Aims
Only small series of PHL have been investigated in literature, nevertheless a non-fortuitous association with Hepatitis C Virus (HCV) infection has been reported among these series. The prognosis is believed to be dismal, with early recurrence and short survival.
Methods
Patients diagnosed with PHL at our institution between 1990 and 2014, among a population of 600 NHL, were retrospectively analyzed. 11 PHL were defined, 10 patients had a B-cell lymphoma, DLBCL in 6. The prevalence of HCV infection was 72%. Combination CHT was the mainstay of treatment for PHL. 10 patients were treated with CHT (10/11 : 90%). In 7 patients, the multi-drug regimen we used consisted of the CHOP or a CHOP-like scheme; in 2 of them (diagnosed after 2002) rituximab was added, at standard schedule. In the indolent types a fludarabine-based scheme was used. One patient with a single-focal lesion underwent to surgical treatment, with a CR. 11/11 patients achieved complete remission of the disease after the frontline therapy (six CHT courses/surgical treatment) (CR : 100%). Only one patient, 47 years old, Diffuse Large B-Cell Lymphoma, relapsed 144 months after CR: she underwent to retreatment with Rituximab + CHOP with the result of SD, so she underwent to third line treatment with R-Bendamustine, but, due to cardiotoxicity, she had to stop treatment and in the same month died for heart failure.
Results
At time, 10/11 (90%) of patients are alive with a median overall survival (OS) was 123 months (r. 40-228) and median disease- free survival (DFS) was 120 months (range 36-223), no statistically significant differences were found between PHL and other types of NHL in terms of OS and DFS. HCV infection did not appear to influence the results of therapy.
Conclusion
Our study confirms the rarity of PHL, shows a high prevalence of HCV infection, and demonstrates that the outcome of patients with PHL may be favorable.
Session topic: E-poster
Keyword(s): Hepatitis C virus, Lymphoma, Rituximab
Type: Publication Only
Background
Primary Hepatic (PHL) is a rare form of NHL, characterized by the exclusive involvement of the liver at the moment of the diagnosis, whereas other localizations, such as lymph nodes, spleen, bone marrow and peripheral blood, or other tissues are free of disease at least for 6 months after diagnosis. Even if its occurrence is rare, PHL should enter in the differential diagnosis of every space-occupying liver lesion, in particular if they are present in concomitance with normal levels of AFP and/or CEA and in absence of liver cirrhosis.
Aims
Only small series of PHL have been investigated in literature, nevertheless a non-fortuitous association with Hepatitis C Virus (HCV) infection has been reported among these series. The prognosis is believed to be dismal, with early recurrence and short survival.
Methods
Patients diagnosed with PHL at our institution between 1990 and 2014, among a population of 600 NHL, were retrospectively analyzed. 11 PHL were defined, 10 patients had a B-cell lymphoma, DLBCL in 6. The prevalence of HCV infection was 72%. Combination CHT was the mainstay of treatment for PHL. 10 patients were treated with CHT (10/11 : 90%). In 7 patients, the multi-drug regimen we used consisted of the CHOP or a CHOP-like scheme; in 2 of them (diagnosed after 2002) rituximab was added, at standard schedule. In the indolent types a fludarabine-based scheme was used. One patient with a single-focal lesion underwent to surgical treatment, with a CR. 11/11 patients achieved complete remission of the disease after the frontline therapy (six CHT courses/surgical treatment) (CR : 100%). Only one patient, 47 years old, Diffuse Large B-Cell Lymphoma, relapsed 144 months after CR: she underwent to retreatment with Rituximab + CHOP with the result of SD, so she underwent to third line treatment with R-Bendamustine, but, due to cardiotoxicity, she had to stop treatment and in the same month died for heart failure.
Results
At time, 10/11 (90%) of patients are alive with a median overall survival (OS) was 123 months (r. 40-228) and median disease- free survival (DFS) was 120 months (range 36-223), no statistically significant differences were found between PHL and other types of NHL in terms of OS and DFS. HCV infection did not appear to influence the results of therapy.
Conclusion
Our study confirms the rarity of PHL, shows a high prevalence of HCV infection, and demonstrates that the outcome of patients with PHL may be favorable.
Session topic: E-poster
Keyword(s): Hepatitis C virus, Lymphoma, Rituximab
Abstract: PB1729
Type: Publication Only
Background
Primary Hepatic (PHL) is a rare form of NHL, characterized by the exclusive involvement of the liver at the moment of the diagnosis, whereas other localizations, such as lymph nodes, spleen, bone marrow and peripheral blood, or other tissues are free of disease at least for 6 months after diagnosis. Even if its occurrence is rare, PHL should enter in the differential diagnosis of every space-occupying liver lesion, in particular if they are present in concomitance with normal levels of AFP and/or CEA and in absence of liver cirrhosis.
Aims
Only small series of PHL have been investigated in literature, nevertheless a non-fortuitous association with Hepatitis C Virus (HCV) infection has been reported among these series. The prognosis is believed to be dismal, with early recurrence and short survival.
Methods
Patients diagnosed with PHL at our institution between 1990 and 2014, among a population of 600 NHL, were retrospectively analyzed. 11 PHL were defined, 10 patients had a B-cell lymphoma, DLBCL in 6. The prevalence of HCV infection was 72%. Combination CHT was the mainstay of treatment for PHL. 10 patients were treated with CHT (10/11 : 90%). In 7 patients, the multi-drug regimen we used consisted of the CHOP or a CHOP-like scheme; in 2 of them (diagnosed after 2002) rituximab was added, at standard schedule. In the indolent types a fludarabine-based scheme was used. One patient with a single-focal lesion underwent to surgical treatment, with a CR. 11/11 patients achieved complete remission of the disease after the frontline therapy (six CHT courses/surgical treatment) (CR : 100%). Only one patient, 47 years old, Diffuse Large B-Cell Lymphoma, relapsed 144 months after CR: she underwent to retreatment with Rituximab + CHOP with the result of SD, so she underwent to third line treatment with R-Bendamustine, but, due to cardiotoxicity, she had to stop treatment and in the same month died for heart failure.
Results
At time, 10/11 (90%) of patients are alive with a median overall survival (OS) was 123 months (r. 40-228) and median disease- free survival (DFS) was 120 months (range 36-223), no statistically significant differences were found between PHL and other types of NHL in terms of OS and DFS. HCV infection did not appear to influence the results of therapy.
Conclusion
Our study confirms the rarity of PHL, shows a high prevalence of HCV infection, and demonstrates that the outcome of patients with PHL may be favorable.
Session topic: E-poster
Keyword(s): Hepatitis C virus, Lymphoma, Rituximab
Type: Publication Only
Background
Primary Hepatic (PHL) is a rare form of NHL, characterized by the exclusive involvement of the liver at the moment of the diagnosis, whereas other localizations, such as lymph nodes, spleen, bone marrow and peripheral blood, or other tissues are free of disease at least for 6 months after diagnosis. Even if its occurrence is rare, PHL should enter in the differential diagnosis of every space-occupying liver lesion, in particular if they are present in concomitance with normal levels of AFP and/or CEA and in absence of liver cirrhosis.
Aims
Only small series of PHL have been investigated in literature, nevertheless a non-fortuitous association with Hepatitis C Virus (HCV) infection has been reported among these series. The prognosis is believed to be dismal, with early recurrence and short survival.
Methods
Patients diagnosed with PHL at our institution between 1990 and 2014, among a population of 600 NHL, were retrospectively analyzed. 11 PHL were defined, 10 patients had a B-cell lymphoma, DLBCL in 6. The prevalence of HCV infection was 72%. Combination CHT was the mainstay of treatment for PHL. 10 patients were treated with CHT (10/11 : 90%). In 7 patients, the multi-drug regimen we used consisted of the CHOP or a CHOP-like scheme; in 2 of them (diagnosed after 2002) rituximab was added, at standard schedule. In the indolent types a fludarabine-based scheme was used. One patient with a single-focal lesion underwent to surgical treatment, with a CR. 11/11 patients achieved complete remission of the disease after the frontline therapy (six CHT courses/surgical treatment) (CR : 100%). Only one patient, 47 years old, Diffuse Large B-Cell Lymphoma, relapsed 144 months after CR: she underwent to retreatment with Rituximab + CHOP with the result of SD, so she underwent to third line treatment with R-Bendamustine, but, due to cardiotoxicity, she had to stop treatment and in the same month died for heart failure.
Results
At time, 10/11 (90%) of patients are alive with a median overall survival (OS) was 123 months (r. 40-228) and median disease- free survival (DFS) was 120 months (range 36-223), no statistically significant differences were found between PHL and other types of NHL in terms of OS and DFS. HCV infection did not appear to influence the results of therapy.
Conclusion
Our study confirms the rarity of PHL, shows a high prevalence of HCV infection, and demonstrates that the outcome of patients with PHL may be favorable.
Session topic: E-poster
Keyword(s): Hepatitis C virus, Lymphoma, Rituximab
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