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Master Thesis

Récidives des lymphomes cutanés B diffus à grandes cellules de type jambe : étude rétrospective tricentrique

Abstract : Background: primary cutaneous diffuse large B-cell lymphoma, leg type (PCDLBCL, LT) is a rare aggressive primary cutaneous lymphoma, predominantly affecting the elderly. It is considered to be a localized activated B cell (ABC)-type diffuse large B-cell lymphoma (DLBCL) and should be managed in the same way with rituximab-polychemotherapy (R-PCT) consisting mainly in C(H)OP. Consolidation radiation therapy (RT) in localized disease has been recently proposed in option. Relapses are common and can involve the skin or extracutaneous organs. Objectives: to accurately describe the location of relapses in PCDLBCL, LT and to update overall and specific survival rates. Methods: this is a multicenter retrospective study including all PCDLBCL, LT cases treated with R-CH(O)P between 2008 and 2020. The location of recurrence after complete remission (CR) and survival of the entire cohort were studied. Results: 44 patients from 3 dermatology departments were included. Of the 37 cases (84.1%) who achieved CR after R-PCT, combined with RT for 7 patients, 22 patients (59.4%) relapsed. These recurrences were cutaneous in 19 patients (51.3%) and extra-cutaneous in four (10.8%) including 1 patient with both cutaneous and extra cutaneous involvement. Among the skin recurrences, lesions were restricted to the initial affected area (IAA) in 5 patients (26.3%) while they were observed elsewhere in 14 patients (73.7%). Five-years specific and overall survival rates of the entire cohort were 59% and 39 % respectively with a median progression-free survival and time-to-progression of 14 months. Conclusions: PCDLBCL, LT frequently recurs in the skin but in the majority of cases involves an area distant from the IAA. This may suggest that these recurrences would not have been prevented by RT. The benefit of involved-field RT should be confirmed by prospective studies. PCDLBCL, LT remains a disease with a poor prognosis despite treatment with immunochemotherapy.
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https://dumas.ccsd.cnrs.fr/dumas-03376531
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Submitted on : Wednesday, October 13, 2021 - 3:23:06 PM
Last modification on : Tuesday, November 23, 2021 - 3:15:41 AM

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  • HAL Id : dumas-03376531, version 1

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Alyssa Benarfa. Récidives des lymphomes cutanés B diffus à grandes cellules de type jambe : étude rétrospective tricentrique. Sciences du Vivant [q-bio]. 2021. ⟨dumas-03376531⟩

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