Contributions
Abstract: PB1742
Type: Publication Only
Background
Synchronous multiple primary malignant tumors (sMPMTs) are occasionally diagnosed during screening for a newly diagnosed malignant neoplasm. Lymphoma is one of the most common hematological malignancies, and number of lymphoma patients with sMPMTs seems to grow as the population ages. Since the standard chemotherapy for lymphoma takes a few months, treatment strategy sometimes comes to an issue.
Aims
To answer a clinical question of how to handle sMPMTs in the treatment of lymphoma, we investigated prognostic significance of sMPMTs and suitable treatment strategy for a newly diagnosed lymphoma with sMPMTs.
Methods
We retrospectively analyzed patients with malignant lymphoma newly diagnosed between 2009 and 2015. The definition of sMPMTs was patients who were also diagnosed as a solid tumor within 6 months of the diagnosis of lymphoma. Therapeutic strategy was according to physician’s choice. Impact of sMPMTs on treatment outcome of lymphoma was analyzed. Also, relation between treatment of lymphoma and concomitant solid tumors was closely analyzed.
Results
Total of 505 lymphoma patients was included. Median age was 69 (range20-99). The most common diagnosis was diffuse large B-cell lymphoma (63%), and patients with aggressive lymphoma accounted for 77% (391/505). High risk disease, which was defined as international prognostic score 3 or higher, accounted for 36% (184/505). sMPMTs were identified in 16 patients (3.2%). There was no difference of distribution between patients with and without sMPMTs regarding age, grade of lymphoma, and disease risk. The overall survival (OS) and disease-free survival (DFS) were not significantly different between the two groups (with sMPMTs: 53% and 47% vs. without sMPMTs: 77% and 61% at 3 years, P=0.20 and P=0.31). Cumulative incidence of lymphoma relapse was similar between the two groups (with sMPMTs 29% vs. without sMPMTs 27% at 3 years, P=0.28). In multivariate analyses, age (75 years<) and disease risk (high) were identified significant risk factors for OS, and age was an only significant risk factor for DFS. Existence of sMPMTs was not a significant risk factor for either OS or DFS (OS: HR 1.29, 95%CI 0.52-3.20, P=0.58; DFS: HR 1.06, 95%CI 0.49-2.27, P=0.88). Among 16 patients with sMPMTs, half of the patients had high-risk lymphoma, and half of the solid tumors were gastric cancer. Treatment was initiated for the disease which was diagnosed earlier in all patients except one. Interval from diagnosis to the first treatment was significantly shorter in patients whose lymphoma was treated earlier (median 11 days vs. 38.5 days, P=0.004). OS was not significantly different according to the sequencing of treatment (lymphoma earlier: 59% vs. Solid tumor earlier: 40% at 3 years, P=0.84). In 8 of 10 patients whose lymphoma was treated earlier, treatment of lymphoma was interrupted for the treatment of comorbid solid tumor. Interruption of treatment had no significant effect on OS (interruption+: 60% vs. interruption-: 50% at 3 years, P=0.13).
Conclusion
Existence of sMPMTs was not a significant risk factor for newly diagnosed lymphoma patients. It is important to provide adequate treatment for both lymphoma and solid tumor at physician’s discretion.
Session topic: 20. Aggressive Non-Hodgkin lymphoma - Clinical
Keyword(s): Treatment, Solid tumor, Malignant lymphoma
Abstract: PB1742
Type: Publication Only
Background
Synchronous multiple primary malignant tumors (sMPMTs) are occasionally diagnosed during screening for a newly diagnosed malignant neoplasm. Lymphoma is one of the most common hematological malignancies, and number of lymphoma patients with sMPMTs seems to grow as the population ages. Since the standard chemotherapy for lymphoma takes a few months, treatment strategy sometimes comes to an issue.
Aims
To answer a clinical question of how to handle sMPMTs in the treatment of lymphoma, we investigated prognostic significance of sMPMTs and suitable treatment strategy for a newly diagnosed lymphoma with sMPMTs.
Methods
We retrospectively analyzed patients with malignant lymphoma newly diagnosed between 2009 and 2015. The definition of sMPMTs was patients who were also diagnosed as a solid tumor within 6 months of the diagnosis of lymphoma. Therapeutic strategy was according to physician’s choice. Impact of sMPMTs on treatment outcome of lymphoma was analyzed. Also, relation between treatment of lymphoma and concomitant solid tumors was closely analyzed.
Results
Total of 505 lymphoma patients was included. Median age was 69 (range20-99). The most common diagnosis was diffuse large B-cell lymphoma (63%), and patients with aggressive lymphoma accounted for 77% (391/505). High risk disease, which was defined as international prognostic score 3 or higher, accounted for 36% (184/505). sMPMTs were identified in 16 patients (3.2%). There was no difference of distribution between patients with and without sMPMTs regarding age, grade of lymphoma, and disease risk. The overall survival (OS) and disease-free survival (DFS) were not significantly different between the two groups (with sMPMTs: 53% and 47% vs. without sMPMTs: 77% and 61% at 3 years, P=0.20 and P=0.31). Cumulative incidence of lymphoma relapse was similar between the two groups (with sMPMTs 29% vs. without sMPMTs 27% at 3 years, P=0.28). In multivariate analyses, age (75 years<) and disease risk (high) were identified significant risk factors for OS, and age was an only significant risk factor for DFS. Existence of sMPMTs was not a significant risk factor for either OS or DFS (OS: HR 1.29, 95%CI 0.52-3.20, P=0.58; DFS: HR 1.06, 95%CI 0.49-2.27, P=0.88). Among 16 patients with sMPMTs, half of the patients had high-risk lymphoma, and half of the solid tumors were gastric cancer. Treatment was initiated for the disease which was diagnosed earlier in all patients except one. Interval from diagnosis to the first treatment was significantly shorter in patients whose lymphoma was treated earlier (median 11 days vs. 38.5 days, P=0.004). OS was not significantly different according to the sequencing of treatment (lymphoma earlier: 59% vs. Solid tumor earlier: 40% at 3 years, P=0.84). In 8 of 10 patients whose lymphoma was treated earlier, treatment of lymphoma was interrupted for the treatment of comorbid solid tumor. Interruption of treatment had no significant effect on OS (interruption+: 60% vs. interruption-: 50% at 3 years, P=0.13).
Conclusion
Existence of sMPMTs was not a significant risk factor for newly diagnosed lymphoma patients. It is important to provide adequate treatment for both lymphoma and solid tumor at physician’s discretion.
Session topic: 20. Aggressive Non-Hodgkin lymphoma - Clinical
Keyword(s): Treatment, Solid tumor, Malignant lymphoma