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Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research

2973 - A Prospective Multicenter Study of Primary Breast Lymphoma in the rituximab era: prognostic implication of beta 2 microglobulin and interlukin-6 & interlukin-10

Date

20 Oct 2018

Session

Poster display session: Biomarkers, Gynaecological cancers, Haematological malignancies, Immunotherapy of cancer, New diagnostic tools, NSCLC - early stage, locally advanced & metastatic, SCLC, Thoracic malignancies, Translational research

Topics

Cytotoxic Therapy

Tumour Site

Lymphomas

Presenters

Lobna Ezz Elarab

Citation

Annals of Oncology (2018) 29 (suppl_8): viii359-viii371. 10.1093/annonc/mdy286

Authors

L. Ezz Elarab1, E. Hamada2, A. Mostafa1, A. Saber2, M. Abdel-Gawad3, R.M. Haggag4, H.D. Darwish5, S.A. Elhassanin6, M. Swellam7

Author affiliations

  • 1 Clinical Oncology, Ain Shams University Faculty of Medicine, 11566 - Cairo/EG
  • 2 Clinical Oncology, Minya University Medical School, 11432 - Minya/EG
  • 3 Clinical Oncology, faculty of medicine, Assuit University, Cairo/EG
  • 4 Medical Oncology, Zagazig University Faculty of Medicine, 44519 - Zagazig/EG
  • 5 Medical Oncology, Damietta Cancer Institute (DCI), 12324 - Damietta/EG
  • 6 Clinical Oncology, faculty of medicine, Menoufiia University, Cairo/EG
  • 7 Biochemestry,genetic Engineering And Biotechnology, National Research Center ,Egypt, Cairo/EG
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Resources

Abstract 2973

Background

Primary breast diffuse large B-cell lymphoma (DLBCL) is a rare entity representing ≤ 2% of extra-nodal non-Hodgkin lymphoma. We aimed to define clinical profile, prognostic factors and the incidence of the central nervous system (CNS) relapse in the era of rituximab and clarify the prognostic value of beta2 microglobulin(B2M), interlukins-6 (IL-6) and interlukin -10(IL-10).

Methods

Between Jan 2012 to Dec 2016, a prospective analysis of 28 patients presenting to 7 academic Egyptian centers. All patients were females. Only patients with newly diagnosed stage I and II disease DLBCL were included. Patients with evidence of baseline CNS disease and patients with hepatitis B and HIV were excluded. All patients were scheduled to receive R-CHOP protocol plus involved- field radiotherapy. The prognostic significance of B2M, and IL-6 and 10 were assessed.

Results

About 75% presented with breast mass, 4 cases with inflammatory symptoms, 3 cases were discovered by mammography. Right breast was more involved (64%), 86% had ≤ 1 ECOG performance status, and LDH elevated was in 39% and 18% had B symptoms. HCV was positive in 32% (9 patients). Stage I was detected in 57%. The stage–modified International prognostic index was ≤1 in 54%. Ten cases underwent breast surgery (2 modified radical mastectomy, 8 conservative breast surgery). Complete response was achieved in 23/28 (82%) with median follow-up of 28 months, 39% of patients had relapsed, contralateral breast was the site of initial relapse in two cases, 11% developed CNS relapse and 21% in other nodal and extranodal sites. Three years disease free survival and overall survival were 68% and 79%. Favorable prognostic factors according to univariate analysis were stage I, IPI≤1, tumor size < 5cm, B2M. IL6 and IL-10, while for multivariate analysis they were IPI≤1 and B2 M and IL-6.

Conclusions

Primary breast DLBCL has high rate of CNS relapse in spite of era of rituximab so CT or MRI of CNS is necessary during follow-up. Prophylaxis to CNS should be considered in the initial treatment to improve outcome. In addition, assessment of pretreatment serum levels of B2M, and IL-6 in newly diagnosed DLBCL may indicate a possible prognostic role.

Clinical trial identification

Legal entity responsible for the study

Lobna Ezz el-arab.

Funding

Has not received any funding.

Editorial Acknowledgement

Disclosure

All authors have declared no conflicts of interest.

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