Contributions
Abstract: PB1884
Type: Publication Only
Background
Primary Cutaneous B-Cell Lymphoma (PCBCL) comprises a rare group of cutaneous Non-Hodgkin’s lymphomas (NHLs) with an estimated annual incidence of 2.5 per 1,000,000 persons. They usually present with papules or nodules on the head, trunk, and/or extremities. The International Society for Cutaneous Lymphoma (ISCL) and the European Organization for Research and Treatment of Cancer (EORTC) developed a new way to classify PCBCL into three different subtypes. Indolent subtypes include Primary Cutaneous Marginal Zone Lymphoma (PCMZL) and Primary Cutaneous Follicular Center Lymphoma (PCFCL). Primary Cutaneous Diffuse Large B-Cell Lymphoma (PCDLBCL) is an aggressive subtype with a fatality rate of 50%. The Cutaneous Lymphoma International Prognostic Index (CLIPI) can risk stratify indolent subtypes, but criteria do not include age. Here we present our single institutional analysis of clinicopathological features and outcomes of patients with PCBCL.
Aims
To analyze clinical and laboratory characteristics such as age, lesion characteristics, hematological parameters, and treatment modalities in order to determine their impact on progression free survival (PFS) in PCBCL.
Methods
This is a retrospective study of patients evaluated at Moffitt Cancer Center between January 1990 and December 2016. Patients were identified using our PCBCL database and diagnosis was verified by independent hematopathologists and dermatopathologists. Staging was determined according to ISCL/EORTC recommendations. Demographics, lymphoma subtype, stage, disease course, and CLIPI scores were collected. Kruskal Wallis ANOVA and Fisher’s Exact tests were used to compare differences among the four subtypes for continuous and categorical variables, respectively. Kaplan Meier curves were produced to estimate PFS for different strata, and differences among the strata were tested using the log-rank test.
Results
We identified 37 patients who met diagnostic criteria for PCBCL (35% PCFCL, 40.5% PCMZL, 13.5% PCDLBCL, and 11% indolent, unspecified). Male:female ratio was 2.4:1. 51% of patients were ≥60 years old (yo) and 49% were <60 yo. 54% had stage T1 disease, 27% T2, and 19% T3. Median PFS for patients <60 was 1.1 years, but was not reached for those ≥60. Mean follow-up time was 2.6 years for all patients. Log rank test showed a statistically significant difference in PFS between the two age groups (p=0.01). This was consistent when comparing PFS by age in both high (PCDLBCL) and low grade (indolent) subtypes. PFS according to stage in indolent subtypes showed a marginally statistically significant difference (p<0.06). Stratification of patients according to CLIPI did not show a significant difference in PFS among indolent subtypes.
Conclusion
We found that age is a highly statistically significant prognostic parameter in PCBCL, as patients ≥60 years had a longer PFS compared to younger patients, even after adjusting for stage and CLIPI. This is an interesting finding as most NHL studies demonstrated a negative impact of advanced age on PFS. Our results suggested that age is a possible novel prognostic indicator in patients with PCBCL, however validation on a larger sample set is needed.
Session topic: 19. Indolent Non-Hodgkin lymphoma - Clinical
Keyword(s): Hematological malignancy, DLBCL, Cutaneous lymphoma, B cell lymphoma
Abstract: PB1884
Type: Publication Only
Background
Primary Cutaneous B-Cell Lymphoma (PCBCL) comprises a rare group of cutaneous Non-Hodgkin’s lymphomas (NHLs) with an estimated annual incidence of 2.5 per 1,000,000 persons. They usually present with papules or nodules on the head, trunk, and/or extremities. The International Society for Cutaneous Lymphoma (ISCL) and the European Organization for Research and Treatment of Cancer (EORTC) developed a new way to classify PCBCL into three different subtypes. Indolent subtypes include Primary Cutaneous Marginal Zone Lymphoma (PCMZL) and Primary Cutaneous Follicular Center Lymphoma (PCFCL). Primary Cutaneous Diffuse Large B-Cell Lymphoma (PCDLBCL) is an aggressive subtype with a fatality rate of 50%. The Cutaneous Lymphoma International Prognostic Index (CLIPI) can risk stratify indolent subtypes, but criteria do not include age. Here we present our single institutional analysis of clinicopathological features and outcomes of patients with PCBCL.
Aims
To analyze clinical and laboratory characteristics such as age, lesion characteristics, hematological parameters, and treatment modalities in order to determine their impact on progression free survival (PFS) in PCBCL.
Methods
This is a retrospective study of patients evaluated at Moffitt Cancer Center between January 1990 and December 2016. Patients were identified using our PCBCL database and diagnosis was verified by independent hematopathologists and dermatopathologists. Staging was determined according to ISCL/EORTC recommendations. Demographics, lymphoma subtype, stage, disease course, and CLIPI scores were collected. Kruskal Wallis ANOVA and Fisher’s Exact tests were used to compare differences among the four subtypes for continuous and categorical variables, respectively. Kaplan Meier curves were produced to estimate PFS for different strata, and differences among the strata were tested using the log-rank test.
Results
We identified 37 patients who met diagnostic criteria for PCBCL (35% PCFCL, 40.5% PCMZL, 13.5% PCDLBCL, and 11% indolent, unspecified). Male:female ratio was 2.4:1. 51% of patients were ≥60 years old (yo) and 49% were <60 yo. 54% had stage T1 disease, 27% T2, and 19% T3. Median PFS for patients <60 was 1.1 years, but was not reached for those ≥60. Mean follow-up time was 2.6 years for all patients. Log rank test showed a statistically significant difference in PFS between the two age groups (p=0.01). This was consistent when comparing PFS by age in both high (PCDLBCL) and low grade (indolent) subtypes. PFS according to stage in indolent subtypes showed a marginally statistically significant difference (p<0.06). Stratification of patients according to CLIPI did not show a significant difference in PFS among indolent subtypes.
Conclusion
We found that age is a highly statistically significant prognostic parameter in PCBCL, as patients ≥60 years had a longer PFS compared to younger patients, even after adjusting for stage and CLIPI. This is an interesting finding as most NHL studies demonstrated a negative impact of advanced age on PFS. Our results suggested that age is a possible novel prognostic indicator in patients with PCBCL, however validation on a larger sample set is needed.
Session topic: 19. Indolent Non-Hodgkin lymphoma - Clinical
Keyword(s): Hematological malignancy, DLBCL, Cutaneous lymphoma, B cell lymphoma