Outcomes and Toxicities in Patients With Diffuse-Large B Cell Lymphoma Involving the Gastrointestinal Tract and Digestive Organs

Authors

Gohar S Manzar
Elaine E Cha
Kelsey L Corrigan
Alison K Yoder
Benjamin R Schrank
Lewis F Nasr
Dai Chihara
Luis Malpica Castillo
Ranjit Nair
Preetesh Jain
Sattva S Neelapu
Maria A Rodriguez
Paolo Strati
Loretta J Nastoupil
Jillian R Gunther
Bouthaina S Dabaja
Chelsea C Pinnix
Susan Y Wu
Penny Q Fang

Publication Date

1-1-2024

Journal

Frontiers in Oncology

Abstract

BACKGROUND: Diffuse large B-cell lymphoma (DLBCL) involving the gastrointestinal (GI) organs is rare, and real-world outcomes after combined modality therapy (CMT) with systemic therapy (ST) and radiotherapy (RT) are not well-characterized, particularly in the contemporary era. We characterized outcomes in a large cohort of GI-DLBCL patients treated with ST alone or CMT.

METHODS: Patients with GI-DLBCL treated at a single institution were retrospectively reviewed. Kaplan-Meier and Cox regression models estimated survival. Multivariable analyses were conducted using the Cox proportional hazards model.

RESULTS: Of 204 patients, gastric involvement was most common (63%). Most presented with early-stage disease (61%). All patients received ST and 65 patients (32%) received RT, 88% as part of first-line CMT. Median dose was 36 Gy (IQR 30.6-39.6) in 18 fractions (IQR 17-22). Median follow-up was 46 months. Five-year overall survival (OS) and progression-free survival (PFS) was 88% and 84%, respectively; complete response (CR) rate was 82%. Improved OS associated with low IPI (

CONCLUSION: GI-DLBCL patients have favorable outcomes after CMT with minimal late toxicity. CMT may be offered with abridged systemic regimens with equivalent outcomes. Stomach directed-RT may mitigate relapse risk associated with incomplete disease response or bulky disease.

Comments

Supplementary Materials

Data Availability Statement

PMID: 39324011