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Outcomes of primary gastrointestinal diffuse large B cell lymphoma in the rituximab era
Luyao Zhang1,2, Jianwen Zhou3, Yanyan Sun4
1Henan Provincial Clinical Research Center for Pediatric Diseases, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou Children's Hospital, Henan Children's Hospital, Zhengzhou, China.
Background:
Primary gastrointestinal diffuse large B-cell lymphoma (PGI-DLBCL) constitutes 30%-40% of primary extranodal lymphomas. While rituximab has significantly improved survival in nodal DLBCL, its impact on the prognosis of PGI-DLBCL remains inadequately defined. This study aimed to compare the survival outcomes of PGI-DLBCL patients between the pre-rituximab and rituximab eras.
Methods:
We identified all PGI-DLBCL cases from the Surveillance, Epidemiology, and End Results (SEER) registry (1975-2015). Patients were categorized into pre-rituximab (diagnosed before 2006) and rituximab-era (diagnosed in or after 2006) groups. Overall survival (OS) and lymphoma-specific survival (LSS) were compared between the two groups.
Results:
Among 2780 patients, median age was 68 years; 72.2% had stage I/II disease. The rituximab-era group showed significantly longer median OS (119 months vs. 43 months, p < 0.0001). Median LSS was not reached in the rituximab era versus 115 months in the pre-rituximab group (p < 0.0001), with an 11-year LSS rate of 58%. Multivariable analysis confirmed that the rituximab era, younger age, early stage, and chemotherapy were associated with better OS and LSS.
Conclusions:
PGI-DLBCL represents a significant subset of non-Hodgkin lymphomas and is the most prevalent type within the gastrointestinal tract. Younger age, female, Asian, marital status, early-stage and with chemotherapy, as well as the period of lymphoma diagnosis (rituximab era), are associated with better prognosis.
