[Analysis of Clinical Feature and Treatment Outcome of Patients with Renal Diffuse Large B Cell Lymphoma].

OBJECTIVE

To analyse the clinical feature and treatment outcome of patients with renal diffuse large B cell lymphoma(DLBCL).

METHODS

The clinical data of 24 patients with renal DLBCL were collected and retrospectively analysed, the clinical features, laboratorial data, survival and prognostic factors were analysed.

RESULTS

In our center, the incidence of renal DLBCL was 5.3% in all DLBCL patients, 3 cases were primary renal DLBCL and 21 cases were secondary renal DLBCL, the median age was 52.5 years, 21(87.5%) patients belonged to III and IV stage, 20 (83.3%) patients had high-intermediate and high risk by IPI, 50% patients had more than 3 extranodal organs involvement, and the higher proliferation index(KI-67≥80%) was present in 75.0% of patients. The overall response rate(ORR) for the whole group was 66.7%, the complete response(CR) rate was 37.5%, the 3y,5-year progression-free survival(PFS) rate was 49.5% and 49.5%, the 3y,5-year overall survival rate was 66.0% and 49.5% respectively. Rituximab could improve the survival of patients, the 3-year PFS rate was 71.4% vs 30.0%. High-dose chemotherapy was superior to CHOP-like regimens, 3-year PFS was 75% vs 41.3%, and hematopoietic stem cell transplantation improved prognosis of patients. Clinical stage, IPI score, the level of WBC, LDH and albumin, the existence of renal failure and coagulopathy, the numbers of extranodal organs involvement, initial treatment outcome and the level of KI-67 were prognosis-related factors for overall survival.

CONCLUSION

Renal DLBCL often occures in eldly men with lower incidence and poor prognosis, its clinical and pathological features are highly aggressive. Rituximab and high-dose chemotherapy can improve the survival of patients, and HSCT can further improve the survival and reduce the recurrence of patients.