Original Article
A Predictive Model for Aggressive Non-Hodgkin's Lymphoma
N Engl J Med 1993; 329:987-994September 30, 1993
- Abstract
Background
Although many patients with intermediate-grade or high-grade (aggressive) non-Hodgkin's lymphoma are cured by combination chemotherapy, the remainder are not cured and ultimately die of their disease. The Ann Arbor classification, used to determine the stage of this disease, does not consistently distinguish between patients with different long-term prognoses. This project was undertaken to develop a model for predicting outcome in patients with aggressive non-Hodgkin's lymphoma on the basis of the patients' clinical characteristics before treatment.
Methods
Adults with aggressive non-Hodgkin's lymphoma from 16 institutions and cooperative groups in the United States, Europe, and Canada who were treated between 1982 and 1987 with combination-chemotherapy regimens containing doxorubicin were evaluated for clinical features predictive of overall survival and relapse-free survival. Features that remained independently significant in step-down regression analyses of survival were incorporated into models that identified groups of patients of all ages and groups of patients no more than 60 years old with different risks of death.
Results
In 2031 patients of all ages, our model, based on age, tumor stage, serum lactate dehydrogenase concentration, performance status, and number of extranodal disease sites, identified four risk groups with predicted five-year survival rates of 73 percent, 51 percent, 43 percent, and 26 percent. In 1274 patients 60 or younger, an age-adjusted model based on tumor stage, lactate dehydrogenase level, and performance status identified four risk groups with predicted five-year survival rates of 83 percent, 69 percent, 46 percent, and 32 percent. In both models, the increased risk of death was due to both a lower rate of complete responses and a higher rate of relapse from complete response. These two indexes, called the international index and the age-adjusted international index, were significantly more accurate than the Ann Arbor classification in predicting long-term survival.
Conclusions
The international index and the age-adjusted international index should be used in the design of future therapeutic trials in patients with aggressive non-Hodgkin's lymphoma and in the selection of appropriate therapeutic approaches for individual patients.
Media in This Article
Figure 1
Survival According to Risk Group Defined by the International Index.Figure 2
Survival among the 1274 Younger Patients (≤ 60 Years) According to Risk Group Defined by the Age-Adjusted International Index.Article Activity
- Article
Combination chemotherapy has transformed aggressive non-Hodgkin's lymphoma from a fatal disease into one that is often curable. However, many patients still die of their disease, underscoring the need for more accurate methods of prospectively identifying patients with different long-term prognoses. The identification of those at “high” or “low” risk could have important therapeutic implications. Patients at high risk who are not effectively treated with current regimens may benefit from new experimental approaches, whereas those at low risk may do well with standard therapy but sustain severe toxic reactions without additional benefit if they are treated with experimental regimens. The identification of different risk groups would also aid in the design and interpretation of therapeutic trials.
The tumor stage of patients with aggressive non-Hodgkin's lymphoma is currently determined with the Ann Arbor classification, which was originally developed for Hodgkin's disease1. This classification emphasizes the distribution of nodal disease sites because Hodgkin's disease commonly spreads through contiguous groups of lymph nodes1. Since the patterns of disease spread in Hodgkin's disease and non-Hodgkin's lymphoma are different, it is not surprising that the Ann Arbor classification system is less accurate in identifying prognostic subgroups of patients with aggressive non-Hodgkin's lymphoma2.
In previous analyses of relatively small numbers of patients with this disease, a variety of clinical characteristics were consistently associated with outcome: the age at diagnosis, the presence or absence of systemic (B) symptoms, performance status, the serum lactate dehydrogenase (LDH) concentration, the number of nodal and extranodal sites of disease, tumor size, and the distinction between localized disease (Ann Arbor stage I or II) and advanced disease (stage III or IV)3-13. These features were thought to reflect the tumor's growth and invasive potential (LDH level, tumor stage, tumor size, number of nodal and extranodal sites of disease, and the presence or absence of bone marrow involvement), the patient's response to the tumor (performance status and status for B symptoms), and the patient's ability to tolerate intensive therapy (performance status, bone marrow involvement, and age). Many investigators identified a subgroup of clinical features that remained independently significant in multivariate analyses of their patients and used this subgroup to develop prognostic models that would predict a given patient's risk of death4-11,13. Although the specific clinical features in these models differed, all models included the measurements of disease volume and extent of tumor involvement at presentation. To develop a better prognostic-factor model for aggressive non-Hodgkin's lymphoma, 16 institutions and cooperative groups in the United States, Europe, and Canada participated in the project.
Methods
Characteristics of the Patients
Participating centers submitted data on each eligible patient included in electronic files.
Adult patients were eligible for this study if they had diffuse mixed, diffuse large-cell, or large-cell immunoblastic lymphoma (International Working Formulation14 categories F, G, and H); diffuse centroblastic-centrocytic, centroblastic, immunoblastic, or unclassified high-grade lymphoma (Kiel classification15); or diffuse mixed lymphocytic-histiocytic or diffuse histiocytic lymphoma (Rappaport classification16). All the patients were treated with a combination-chemotherapy regimen containing doxorubicin as part of a phase 2 or 3 study between 1982 and 1987. The inclusion of only patients who had completed therapy by 1987 ensured a minimum of 3 years of follow-up for all patients and a median of 4 1/2 years of follow-up for surviving patients. The stages of the tumors were determined and their pathologic characteristics were reviewed according to guidelines at the participating institutions.
The clinical features evaluated for potential prognostic importance were sex, age, tumor stage, performance status, B symptoms, sites of lymphomatous involvement, number of extranodal disease sites, size of the largest tumor, and serum concentrations of LDH, albumin, and beta2-microglobulin. The Ann Arbor stage of the tumor was designated as I, II non-bulky (largest tumor dimension, <10 cm), II bulky (largest dimension, ≥ 10 cm), III, or IV. Performance status was assessed according to the Eastern Cooperative Oncology Group scale, in which 0 indicated that the patient had no symptoms; 1, the patient had symptoms but was ambulatory; 2, the patient was bedridden less than half the day; 3, the patient was bedridden half the day or longer; and 4, the patient was chronically bedridden and required assistance with the activities of daily living. Performance status was classified as 0 or 1 (the patient was ambulatory) or 2, 3, or 4 (the patient was not ambulatory) (equivalent Karnofsky scores, ≥ 80 and ≤ 70). B symptoms were defined as recurrent fever (temperature, >38.3 °C [101 °F]), night sweats, or the loss of more than 10 percent of body weight. The recorded sites of extranodal lymphomatous involvement included the bone marrow, gastrointestinal tract, liver, lung, central nervous system, and other sites; the numbers of extranodal disease sites were recorded as 0, 1, or more than 1. Splenic involvement was also recorded. The largest dimension of the largest site of bulky disease was measured and reported as being less than 10 cm or as 10 cm or more. The serum LDH level was expressed as the ratio of the measured value to the upper limit of the normal range reported in the laboratory of each participating institution.
Assessment of Response
A complete response to treatment was defined by the participating institutions as the disappearance of all clinical evidence of disease and the normalization of all laboratory values and radiographic results that had been abnormal before treatment. The relapse-free survival of patients with complete responses was measured as the interval between the end of treatment and relapse or death or the date of the last follow-up evaluation in patients who had no relapse. Survival was measured as the interval between the beginning of treatment and death or the date of the last follow-up evaluation.
Statistical Analysis
The univariate associations between response and individual clinical features were analyzed with Fisher's exact test for two-by-k tables17. Relapse-free survival among patients with complete responses and overall survival among all patients were estimated with the method of Kaplan and Meier18. The univariate associations between individual clinical features and overall survival and relapse-free survival were determined with the log-rank test19.
Since all centers had not originally gathered all the requested information on their patients, data on several prognostic factors were missing from the patients' files. No data on outcome were missing. Missing data were dealt with by carrying out “complete case” analyses, in which patients were excluded from particular analyses if their files did not contain data on the required variables. This method did not bias analysis, since the availability of data at each center was determined by the data collection at the time of treatment rather than by the eventual outcome.
Features independently associated with overall survival and relapse-free survival were identified in multivariate analyses by proportional-hazards regression20. Step-down regression methods were used to build parsimonious statistical models for the association of prognostic factors with overall survival and relapse-free survival among patients with complete responses. Time-dependent death rates (hazard functions) were estimated according to the nonparametric kernel smoothing methods of Gray21.
Results
Univariate Analysis of Predictive Features
The presenting characteristics of the 3273 patients with tumors in Ann Arbor stages I through IV who were included in the analysis are shown in Table 1Table 1
Characteristics of 3273 Patients Presenting with Aggressive Non-Hodgkin's Lymphoma.. Of these patients, 66 percent had complete responses. The five-year relapse-free survival rate among the patients with complete responses was 59 percent, and the five-year overall survival among all patients was 52 percent (Table 2Table 2
Outcome According to the Patients' Characteristics.). The associations between the patients' characteristics and the response rate, relapse-free survival among those with complete responses, and overall survival are shown in Table 2. Given the size of the study population, it is not surprising that the majority of the listed clinical characteristics were significantly associated with outcome.Independent Prognostic Factors and the Prognostic-Factor Model
Information on seven prognostic factors (age at diagnosis, performance status, serum LDH level, Ann Arbor stage, tumor size, number of extranodal disease sites, and presence or absence of B symptoms) that had been associated with outcome in many previous studies3-13 was complete for 1872 patients, of whom 1385 (74 percent) were randomly selected as a training sample in which to identify independent prognostic factors to form a model. A training sample of nearly 75 percent was chosen because it would be large enough to detect a 20 percent increase in the relative risk of death associated with even a relatively rare characteristic.
The step-down regression analysis of overall survival in the training sample evaluated 12 variables: the 7 prognostic factors mentioned above, 4 individual sites of extranodal disease (bone marrow, liver, lung, and central nervous system), and the spleen. These 12 variables included all those in our data set except sex (which was not associated with survival), gastrointestinal involvement (which had a statistically significant but clinically unimportant association with survival [Table 2]), and serum beta2-microglobulin and albumin levels (on which we had insufficient data). In the regression analysis, age was coded as 60 years or less or more than 60 years because this dichotomy was most commonly used in previous analyses and because patients 60 or younger were the most likely candidates for intensive experimental therapy. The Ann Arbor stage and the number of extranodal disease sites were coded so that the individual categories and all natural dichotomous groupings for each variable were included (e.g., Ann Arbor stage I vs. II vs. III vs. IV; stage I vs. stages II through IV; stage I or II non-bulky disease vs. stage II bulky disease, stage III, or stage IV; and stage I or II vs. stage III or IV.) The most discriminating cutoff point for serum LDH was determined by applying classification and regression trees (which separate patients into homogeneous subgroups)22 to martingale residuals (the differences between the number of events observed and the number predicted by the model)23. The most predictive cutoff point for LDH was a level 1.2 times normal (≤ 1.2 times normal vs. >1.2 times normal) in both univariate and multivariate analyses; however, a level 1 times normal (≤ 1 vs. >1) was chosen as the cutoff point because it was almost as predictive as 1.2 times normal and easier to use.
The five pretreatment characteristics that remained independently significant in the analysis of the training sample were age (≤ 60 vs. >60 years), tumor stage (stage I or II [localized disease] vs. stage III or IV [advanced disease]), the number of extranodal sites of disease (≤ 1 vs. >1), performance status (0 or 1 vs. ≥ 2), and serum LDH level (≤ 1 times normal vs. >1 times normal) (Table 3Table 3
Factors Independently Prognostic of Overall Survival in the Training Sample.). These five features were used to design a model to predict an individual patient's risk of death -- the international index. Since the relative risks associated with each of the independently significant risk factors were comparable (Table 3), the relative risk of death could be characterized by summing the number of risk factors present at diagnosis. Risk groups were defined by comparing the relative risk of death in patients with each possible number of presenting risk factors (0, 1, 2, 3, 4, or 5) and combining categories with similar relative risks (e.g., 0 with 1 or 4 with 5). Patients were then assigned to one of four risk groups on the basis of their number of presenting risk factors: 0 or 1, low risk; 2, low intermediate risk; 3, high intermediate risk; or 4 or 5, high risk. The survival curves and death rates over time for the four risk groups in the training sample are shown in Figure 1Figure 1Survival According to Risk Group Defined by the International Index.. To provide a basis for comparison, the survival curve and death rate for all 3273 patients in the study are also included (Figure 1).The prognostic-factor model was then applied to a validation sample of patients, which contained the remaining patients with complete data on the seven specified variables (487 of the 1872 patients with complete data) and the other patients with complete data on only the five variables in the final model (159 additional patients; total, 646). The model was equally predictive in the validation sample, identifying four groups of patients at low, low intermediate, high intermediate, or high risk of death (Figure 1). In the training and validation samples, the risk of death was increased primarily in the first three to four years after diagnosis (Figure 1, right panels).
Since the training and validation samples had comparable outcomes, we combined these two groups into a single group for further detailed analysis (Figure 1, bottom panels; Table 4Table 4
Outcome According to Risk Group Defined by the International Index and the Age-Adjusted International Index., international index, all patients). The four risk groups had distinctly different rates of complete response, relapse-free survival, and overall survival (Table 4). For example, the low-risk group had a complete-response rate of 87 percent and a five-year overall survival of 73 percent, whereas the high-risk group had a complete-response rate of only 44 percent and a five-year overall survival of only 26 percent (Table 4, international index, all patients).The Significance of Age in Prognosis
Since the two age groups (≤ 60 vs. >60 years) had significantly different outcomes (Table 2 and Table 3) and the age limit for patients treated by most intensive experimental regimens for non-Hodgkin's lymphoma is 60 years, we also developed an age-adjusted model for younger patients -- the age-adjusted international index. Three of the previously identified risk factors -- tumor stage, performance status, and LDH level -- remained independently significant prognostic factors among the patients in the training sample who were 60 or younger (885 patients) (Table 3). Since the relative risks of death associated with the three risk factors were comparable (Table 3), a younger patient could also be assigned to a risk group by counting the number of risk factors present at diagnosis. The age-adjusted international index was similarly predictive in the training and validation samples (in 885 and 389 patients, respectively, or a total of 1274), justifying our combining these two groups for further analysis (Figure 2Figure 2
Survival among the 1274 Younger Patients (≤ 60 Years) According to Risk Group Defined by the Age-Adjusted International Index.; Table 4, age-adjusted index, patients ≤ 60). The younger patients (≤ 60 years) were assigned to four risk groups according to the number of risk factors at presentation (0, 1, 2, or 3) (Figure 2 and Table 4). The younger patients in the low-risk group had a complete-response rate of 92 percent and a five-year overall survival of 83 percent, whereas those in the high-risk group had a complete-response rate of only 46 percent and a five-year overall survival of only 32 percent (Table 4). As was true of all patients (Table 4, international index, all patients), the increased risk of death among the younger patients was due to both a lower complete-response rate and lower relapse-free survival among those with complete responses.To define the differences between the younger and older patients more specifically, the two age groups were compared by the age-adjusted international index (Table 4). The distribution of the younger patients among the four risk groups was similar to the distribution of the older patients among these groups (Table 4). Although the older patients (>60 years) had complete-response rates that were similar to or only slightly lower than those of the younger patients, the older patients with complete responses had much lower rates of relapse-free survival (Table 4). These data suggested that increased numbers of older patients died of lymphoma rather than of unrelated causes. Consistent with this observation was the finding that the older patients also had an observed death rate that was substantially higher than that of an age-matched cohort (data not shown)24.
Relapse-free Survival among Patients with Complete Responses
If patients with an increased risk of relapse from complete response could be identified before relapse, they might be candidates for experimental approaches to consolidation therapy, such as high-dose chemoradiotherapy with infusion of peripheral-blood stem cells or bone marrow support. For this reason, we also identified the presenting clinical features most closely associated with the risk of relapse from complete response: age (≤ 60 vs. >60 years: relative risk, 1.80; P<0.001), tumor stage (I or II vs. III or IV: relative risk, 1.79; P<0.001), and serum LDH level (≤ 1 times normal vs. >1 times normal: relative risk, 1.47; P<0.001).
International Index and Ann Arbor Stage
Since features other than the Ann Arbor stage were independently associated with overall survival in our analyses (Table 3), a model incorporating these additional features would by definition be more predictive than the Ann Arbor classification system. This is illustrated in Figure 3Figure 3
Survival among 1880 Patients in Ann Arbor Stages II, III, and IV, According to Risk Group Defined by the International Index., which shows the survival of patients in Ann Arbor stage II, III, and IV according to their risk group as defined by the international index.Discussion
The goal of our project was to develop a system for classifying patients with aggressive non-Hodgkin's lymphoma according to universally recognized clinical features. The resulting model applicable to all these patients (the international index) incorporates clinical features that reflect the growth and invasive potential of the tumor (tumor stage, serum LDH level, and number of extranodal disease sites), the patient's response to the tumor (performance status), and the patient's ability to tolerate intensive therapy (age and performance status). The simplified model for younger patients (the age-adjusted international index) uses a subgroup of these clinical features (tumor stage, LDH level, and performance status). Both models identified four risk groups of patients based on both the rate of complete response and the rate of relapse from complete response. The size of the study population and the diversity of the referring institutions and study centers helped ensure that the international index and the age-adjusted index were derived from a broadly representative group. Since recent studies indicate that unselected patients with aggressive non-Hodgkin's lymphoma who are treated with first-, second-, and third-generation chemotherapy regimens have comparable outcomes,25-27 the variety of regimens that contained doxorubicin in our study is unlikely to have influenced the analysis. Furthermore, the international index was equally predictive of survival in two recent series of over 2000 patients treated with intensive third-generation regimens25 (and unpublished data).
We developed separate models -- one for all patients (the international index) and one for younger patients (the age-adjusted international index) -- because the two models may be applicable in different settings. In trials that include patients of all ages, the international index, not restricted according to age, would be more useful. However, in trials of more intensive experimental approaches that are targeted to younger patients, the age-adjusted index could be used.
We retained four risk groups of patients defined by the international index and the age-adjusted index because physicians and investigators may collapse these risk groups differently, depending on their objectives. For example, if the goal is to compare the types of patients who are being treated in specific trials, the relative numbers of patients in all four risk groups should be noted. If the objective is to identify candidates for experimental therapy -- patients whose predicted five-year survival is less than 50 percent with standard regimens -- it would be reasonable to include patients identified as being at high, high intermediate, and perhaps even low intermediate risk according to the international index (Table 4). However, when experimental approaches are specifically designed for younger patients (≤ 60 years), the target population might be patients at high intermediate and high risk as defined by the age-adjusted international index (Table 4). It is important that the target population of a “high-risk” protocol be accurately defined because the results of an experimental approach may be as dependent on the definition of high risk as on the regimen itself28,29. Furthermore, therapeutic approaches should be compared in appropriate, age-matched populations because younger patients generally have more favorable outcomes.
If it were possible to identify patients who enter complete remission but are at increased risk of subsequent relapse, such patients might be candidates for intensive experimental consolidation therapy. However, in our study, the clinical features that correlated with an increased risk of relapse were also associated with a decreased likelihood of obtaining an initial complete remission. Therefore, therapeutic approaches to patients at high risk must be directed toward increasing the low rates of initial complete responses as well as toward improving the durability of those responses.
Although the international index was specifically developed to predict outcome in patients with aggressive non-Hodgkin's lymphoma, it may also have prognostic value in patients with lymphoma that is histologically more indolent. Recent studies indicate that a prognostic-factor model developed for patients with aggressive non-Hodgkin's lymphoma also predicted survival in a small series of patients with follicular lymphoma,30 and that the international index predicted survival in a larger series of similar patients (unpublished data).
Finally, it is important to recognize that the clinical prognostic features incorporated in the international index are, in part, surrogate variables that reflect the biologic heterogeneity of aggressive non-Hodgkin's lymphoma. As additional features such as serologic variables (beta2-microglobulin level31), indexes of tumor-cell proliferation (expression of Ki-67 antigen32 and incorporation of tritiated thymidine33), karyotypic abnormalities,34-37 and aberrant adhesion-molecule38,39 and oncogene40 expression are evaluated in larger numbers of patients, the biologic heterogeneity of this disease may be better understood. In the meantime, clinical prognostic-factor models such as the international index and the age-adjusted index can be used to identify specific risk groups and to compare different therapeutic approaches.
Supported in part by the Arntraud C. Arlinger Fund.
We are indebted to Jane Russell, Mia Donnelly, Stacey Cohen, and Sharon Cassidy of the Dana-Farber Cancer Institute Quality Control Center for assistance with data management; to Jane Weeks, M.D., for thoughtful review of the manuscript; and to Donna Favreau and Judy Nahas for assistance in the preparation of the manuscript.
Source Information
Address reprint requests to Dr. Margaret A. Shipp at the Dana-Farber Cancer Institute, 44 Binney St., Boston, MA 02115.
The following persons are members of the International Non-Hodgkin's Lymphoma Prognostic Factors Project: M.A. Shipp (Dana-Farber Cancer Institute and Harvard Medical School, Boston) and D.P. Harrington (Dana-Farber Cancer Institute and Harvard Medical School, Boston; Eastern Cooperative Oncology Group, Denver), chairpersons; J.R. Anderson (Nebraska Lymphoma Study Group, Omaha; Cancer and Leukemia Group B, Lebanon, N.H.); J.O. Armitage (Nebraska Lymphoma Study Group, Omaha); G. Bonadonna (Istituto Nazionale Tumori, Milan, Italy); G. Brittinger (Bundesministerium fur Forschung und Technologie Study, Essen, Germany); F. Cabanillas (M.D. Anderson Cancer Center, Houston); G.P. Canellos (Dana-Farber Cancer Institute and Harvard Medical School, Boston); B. Coiffier (Groupe d'Etude des Lymphomes de l'Adulte, Paris); J.M. Connors (British Columbia Cancer Agency, Vancouver); R.A. Cowan and D. Crowther (Manchester Lymphoma Group, Manchester, United Kingdom); S. Dahlberg (Southwest Oncology Group, San Antonio, Tex.); M. Engelhard (Bundesministerium fur Forschung und Technologie Study, Essen, Germany); R.I. Fisher (Southwest Oncology Group, San Antonio, Tex.); C. Gisselbrecht (Groupe d'Etude des Lymphomes de l'Adulte, Paris); S.J. Horning (Stanford University, Stanford, Calif.); E. Lepage (Groupe d'Etude des Lymphomes de l'Adulte, Paris); T.A. Lister (St. Bartholomew's Hospital, London); J.H. Meerwaldt (Lymphoma Cooperative Group, European Organisation for Research on Treatment of Cancer, Brussels, Belgium); E. Montserrat (Hospital Clinic i Provincial de Barcelona, Barcelona, Spain); N.I. Nissen (Finsen Institute, Copenhagen, Denmark); M.M. Oken (Eastern Cooperative Oncology Group, Denver); B.A. Peterson (Cancer and Leukemia Group B, Lebanon, N.H.); C. Tondini (Istituto Nazionale Tumori, Milan, Italy); W.A. Velasquez (M.D. Anderson Cancer Center, Houston); and B.Y. Yeap (Dana-Farber Cancer Institute and Harvard Medical School, Boston; Eastern Cooperative Oncology Group, Denver).
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Citing Articles
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Philippe Ratajczak, Christophe Leboeuf, Li Wang, Josette Brière, Irmine Loisel-Ferreira, Catherine Thiéblemont, Wei-Li Zhao, Anne Janin. (2012) BCL2 expression in CD105 positive neoangiogenic cells and tumor progression in angioimmunoblastic T-cell lymphoma. Modern Pathology
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B L Frederiksen, S O Dalton, M Osler, M Steding-Jessen, P de Nully Brown. (2012) Socioeconomic position, treatment, and survival of non-Hodgkin lymphoma in Denmark – a nationwide study. British Journal of Cancer
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Murali Janakiram, Venu K. Thirukonda, Matthew Sullivan, Adam M. Petrich. (2012) Emerging Therapeutic Targets in Diffuse Large B-Cell Lymphoma. Current Treatment Options in Oncology
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James O. Armitage. (2012) My Treatment Approach to Patients With Diffuse Large B-Cell Lymphoma. Mayo Clinic Proceedings 87:2, 161-171
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Fabian Aigner, Dimitri Korol, Anja Maria Schmitt, Michael Odo Kurrer. (2012) Extranodal diffuse large B cell lymphoma of cutaneous follicle centre lymphoma type: a study of 24 patients with non-cutaneous primary limited stage extranodal diffuse large B cell lymphoma in support of a new concept. Histopathologyno-no
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Naoki Wada, Mona A A Zaki, Masaharu Kohara, Hiroyasu Ogawa, Haruo Sugiyama, Shosaku Nomura, Itaru Matsumura, Masayuki Hino, Yuzuru Kanakura, Hiroshi Inagaki, Eiichi Morii, Katsuyuki Aozasa. (2012) Diffuse large B cell lymphoma with an interfollicular pattern of proliferation shows a favourable prognosis: a study of the Osaka Lymphoma Study Group. Histopathologyno-no
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Naoe Goto, Hisashi Tsurumi, Masao Takemura, Nobuhiro Kanemura, Senji Kasahara, Takeshi Hara, Ichiro Yasuda, Masahito Shimizu, Toshiki Yamada, Michio Sawada, Takeshi Takahashi, Tetsuya Yamada, Mitsuru Seishima, Hisataka Moriwaki, Tsuyoshi Takami. (2012) Serum soluble CD27 level is associated with outcome in diffuse large B-cell lymphoma patients treated with R-CHOP. Leukemia & Lymphoma1-21
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Soranobu Ninomiya, Takeshi Hara, Hisashi Tsurumi, Naoe Goto, Kuniaki Saito, Mitsuru Seishima, Tsuyoshi Takami, Hisataka Moriwaki. (2012) Indoleamine 2,3-dioxygenase expression and serum kynurenine concentrations in patients with diffuse large B-cell lymphoma. Leukemia & Lymphoma1-3
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Naoki Wada, Mona A A Zaki, Yumiko Hori, Koji Hashimoto, Machiko Tsukaguchi, Yoichi Tatsumi, Jun Ishikawa, Nobuhiko Tominaga, Hiroto Sakoda, Hironori Take, Mitsuru Tsudo, Maki Kuwayama, Eiichi Morii, Katsuyuki Aozasa. (2012) Tumour-associated macrophages in diffuse large B-cell lymphoma: a study of the Osaka Lymphoma Study Group. Histopathology 60:2, 313-319
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Ha Yeon Lee, Seok Jin Kim, Kihyun Kim, Young Hyeh Ko, Won Seog Kim. (2012) Bone involvement in patients with stage IV diffuse large B-cell lymphoma: does it have a prognostic value?. Leukemia & Lymphoma 53:1, 173-175
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Akiko Meguro, Katsutoshi Ozaki, Kazuya Sato, Iekuni Oh, Shinichiro Fujiwara, Rie Hosonuma, Miyuki Sasazaki, Yuji Kikuchi, Yuji Hirata, Chihiro Yamamoto, Mitsuyo Uesawa, Hiroyuki Kobayashi, Haruko Matsu, Hiroshi Okabe, Eisuke Uehara, Akinori Nishikawa, Raine Tatara, Kaoru Hatano, Chizuru Yamamoto, Tomohiro Matsuyama, Masaki Toshima, Masuzu Ueda, Ken Ohmine, Takahiro Suzuki, Masaki Mori, Tadashi Nagai, Kazuo Muroi, Keiya Ozawa. (2012) Rituximab plus 70% cyclophosphamide, doxorubicin, vincristine and prednisone for Japanese patients with diffuse large B-cell lymphoma aged 70 years and older. Leukemia & Lymphoma 53:1, 43-49
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Laurie H. Sehn, Timothy S. Fenske, Ginna G. Laport. (2012) Follicular Lymphoma: Prognostic Factors, Conventional Therapies, and Hematopoietic Cell Transplantation. Biology of Blood and Marrow Transplantation 18:1, S82-S91
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Marco Gunnellini, Rita Emili, Stefano Coaccioli, Anna Marina Liberati. (2012) The Role of Autologous Stem Cell Transplantation in the Treatment of Diffuse Large B-Cell Lymphoma. Advances in Hematology 2012, 1-10
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Jorge J. Castillo, Brady E. Beltran, Moo-Kon Song, Ivana Ilic, Sirpa Leppa, Heidi Nurmi, Ritsuko Seki, Silvia Uccella, Jun-Min Li, Diana O. Treaba, Dariusz Stachurski, James N. Butera. (2012) The Hans algorithm is not prognostic in patients with diffuse large B-cell lymphoma treated with R-CHOP. Leukemia Research
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Brigita Gregoric, Vesna Zadnik, Barbara Jezersek Novakovic. (2012) The diffuse large B-cell lymphoma - where do we stand now in everyday clinical practice. Radiology and Oncology 1:-1, 1-8
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Qi-chun Cai, Hong Liao, Su-xia Lin, Yi Xia, Xiao-xaio Wang, Yan Gao, Ze-xiao Lin, Jia-bin Lu, Hui-qiang Huang. (2011) High expression of tumor-infiltrating macrophages correlates with poor prognosis in patients with diffuse large B-cell lymphoma. Medical Oncology
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Naoe Goto, Hisashi Tsurumi, Hideko Goto, Yoriko Ino Shimomura, Senji Kasahara, Takeshi Hara, Ichiro Yasuda, Masahito Shimizu, Nobuo Murakami, Takeshi Yoshikawa, Kenji Fukuno, Takeshi Takahashi, Yusuke Kito, Tsuyoshi Takami, Hisataka Moriwaki. (2011) Serum soluble interleukin-2 receptor (sIL-2R) level is associated with the outcome of patients with diffuse large B cell lymphoma treated with R-CHOP regimens. Annals of Hematology
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Milena Todorovic, Bela Balint, Bosko Andjelic, Dejana Stanisavljevic, Nada Kraguljac Kurtovic, Ziv Radisavljevic, Biljana Mihaljevic. (2011) Outcome prediction of advanced mantle cell lymphoma by international prognostic index versus different mantle cell lymphoma indexes: one institution study. Medical Oncology
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Xiaoyang Li, Zhao Liu, Junning Cao, Xiaonan Hong, Jianmin Wang, Fangyuan Chen, Chun Wang, Shanhua Zou, Junmin Li, Zhixiang Shen. (2011) Rituximab in combination with CHOP chemotherapy for the treatment of diffuse large B cell lymphoma in China: a 10-year retrospective follow-up analysis of 437 cases from Shanghai Lymphoma Research Group. Annals of Hematology
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K. Tsukasaki, K. Tobinai, T. Hotta, M. Shimoyama. (2011) Lymphoma Study Group of JCOG. Japanese Journal of Clinical Oncology
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Hossein Ahmadzadehfar, Margarida Rodrigues, Rasoul Zakavi, Peter Knoll, Siroos Mirzaei. (2011) Prognostic significance of the standardized uptake value of pre-therapeutic 18F-FDG PET in patients with malignant lymphoma. Medical Oncology 28:4, 1570-1576
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Juan José Alonso, Araceli Cánovas, José Guillermo Barreiro, Ciriaco Aguirre. (2011) Infectious complications of chemotherapy in clinically aggressive mature B and T cell lymphomas. European Journal of Internal Medicine
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Michael Voulgarelis, Panayiotis D. Ziakas, Aristea Papageorgiou, Evangelia Baimpa, Athanasios G. Tzioufas, Haralampos M. Moutsopoulos. (2011) Prognosis and Outcome of Non-Hodgkin Lymphoma in Primary Sjögren Syndrome. Medicine1
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J. W. Friedberg. (2011) Relapsed/Refractory Diffuse Large B-Cell Lymphoma. Hematology 2011:1, 498-505
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Ling-Ping Chen, Shyh-Jer Lin, Ming-Sun Yu. (2011) Prognostic Value of Platelet Count in Diffuse Large B-Cell Lymphoma. Clinical Lymphoma Myeloma and Leukemia
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Briseis Aschebrook-Kilfoy, Tongzhang Zheng, Francine Foss, Shuangge Ma, Xuesong Han, Qing Lan, Theodore Holford, Yingtai Chen, Brian Leaderer, Nathaniel Rothman, Yawei Zhang. (2011) Polymorphisms in immune function genes and non-Hodgkin lymphoma survival. Journal of Cancer Survivorship
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Francesco Merli, Stefano Luminari, Giuseppe Rossi, Caterina Mammi, Luigi Marcheselli, Alessandra Tucci, Fiorella Ilariucci, Annalisa Chiappella, Maurizio Musso, Alice Di Rocco, Caterina Stelitano, Isabel Alvarez, Luca Baldini, Patrizio Mazza, Flavia Salvi, Annalisa Arcari, Alberto Fragasso, Paolo G. Gobbi, Anna Marina Liberati, Massimo Federico. (2011) Cyclophosphamide, doxorubicin, vincristine, prednisone and rituximab versus epirubicin, cyclophosphamide, vinblastine, prednisone and rituximab for the initial treatment of elderly “fit” patients with diffuse large B-cell lymphoma: results from the ANZINTER3 trial of the Intergruppo Italiano Linfomi. Leukemia & Lymphoma1-8
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Ye-Xiong Li, Qing-Feng Liu, Wei-Hu Wang, Jing Jin, Yong-Wen Song, Shu-Lian Wang, Yue-Ping Liu, Xin-Fan Liu, Li-Qiang Zhou, Zi-Hao Yu. (2011) Failure patterns and clinical implications in early stage nasal natural killer/T-cell lymphoma treated with primary radiotherapy. Cancer 117:22, 5203-5211
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Moo-Kon Song, Joo-Seop Chung, Ho-Jin Shin, Sang-Min Lee, Su-Ee Lee, Ho-Sup Lee, Gyeong-Won Lee, Seong-Jang Kim, Seok-Mo Lee, Dong-Seop Chung. (2011) Clinical significance of metabolic tumor volume by PET/CT in stages II and III of diffuse large B cell lymphoma without extranodal site involvement. Annals of Hematology
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Bin-Tao Huang, Qing-Chun Zeng, Jessica Yu, Zhen Xiao, Bing-Sheng Li, Chun-Lai Zhang, Hong-Bo Ji. (2011) How to determine post-RCHOP therapy for risk-tailored adult patients with diffuse large B-cell lymphoma, addition of maintenance rituximab or observation: multicenter experience. Journal of Cancer Research and Clinical Oncology
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R. Griffiths, J. Mikhael, M. Gleeson, M. Danese, M. Dreyling. (2011) Addition of rituximab to chemotherapy alone as first-line therapy improves overall survival in elderly patients with mantle cell lymphoma. Blood 118:18, 4808-4816
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Suguru Fukuhara, Takashi Watanabe, Wataru Munakata, Masakazu Mori, Dai Maruyama, Sung-Won Kim, Yukio Kobayashi, Hirokazu Taniguchi, Akiko M. Maeshima, Ryuji Tanosaki, Yoshihiro Matsuno, Kensei Tobinai. (2011) Bulky disease has an impact on outcomes in primary diffuse large B-cell lymphoma of the breast: a retrospective analysis at a single institution. European Journal of Haematology 87:5, 434-440
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Tove Wästerlid, Björn Jonsson, Hans Hagberg, Mats Jerkeman. (2011) Population based study of prognostic factors and treatment in adult Burkitt lymphoma: a Swedish Lymphoma Registry study. Leukemia & Lymphoma 52:11, 2090-2096
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Yawei Zhang, Ying Dai, Tongzhang Zheng, Shuangge Ma. (2011) Risk factors of non-Hodgkin's lymphoma. Expert Opinion on Medical Diagnostics 5:6, 539-550
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Anne H. Blaes, Linan Ma, Yan Zhang, Bruce A. Peterson. (2011) Quality of life appears similar between survivors of indolent and aggressive non-Hodgkin lymphoma. Leukemia & Lymphoma 52:11, 2105-2110
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Helen Marr, Gail L Jones, Graham H Jackson, Wendy Osborne. (2011) Diagnosis and management of haematological malignancies in older people. Reviews in Clinical Gerontology 21:04, 297-311
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Bhagwant Rai Mittal, Kuruva Manohar, Pankaj Malhotra, Reena Das, Raghava Kashyap, Anish Bhattacharya, Neelam Varma, Subhash Varma. (2011) Can fluorodeoxyglucose positron emission tomography/computed tomography avoid negative iliac crest biopsies in evaluation of marrow involvement by lymphoma at time of initial staging?. Leukemia & Lymphoma 52:11, 2111-2116
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Abhimanyu Ghose, Namrata Sethi, Guiyuan Li, Rekha Chaudhary. (2011) Chemotherapy Versus Surgery in Primary B-Cell Lymphoma Masquerading as Klatskin Tumor—A Diagnostic and Therapeutic Dilemma. American Journal of Therapeutics 18:6, e255-e257
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Julie M Vose. (2011) Intensified chemotherapy for diffuse large B-cell lymphomas. The Lancet 378:9806, 1828-1829
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Christian Récher, Bertrand Coiffier, Corinne Haioun, Thierry Jo Molina, Christophe Fermé, Olivier Casasnovas, Catherine Thiéblemont, André Bosly, Guy Laurent, Franck Morschhauser, Hervé Ghesquières, Fabrice Jardin, Serge Bologna, Christophe Fruchart, Bernadette Corront, Jean Gabarre, Christophe Bonnet, Maud Janvier, Danielle Canioni, Jean-Philippe Jais, Gilles Salles, Hervé Tilly. (2011) Intensified chemotherapy with ACVBP plus rituximab versus standard CHOP plus rituximab for the treatment of diffuse large B-cell lymphoma (LNH03-2B): an open-label randomised phase 3 trial. The Lancet 378:9806, 1858-1867
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Min Kyoung Kim, Cheolwon Suh, Hyun Sook Chi, Hee Soon Cho, Young Kyung Bae, Kyung Hee Lee, Gyeong-Won Lee, In-Suk Kim, Hyeon-Seok Eom, Sun-Young Kong, Sung Hwa Bae, Hun Mo Ryoo, Im-Hee Shin, Yeung-Chul Mun, Hwasoon Chung, Myung Soo Hyun. (2011) VEGFA and VEGFR2 genetic polymorphisms and survival in patients with diffuse large B cell lymphoma. Cancer Scienceno-no
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Christoph Wyen, Björn Jensen, Marcus Hentrich, Jan Siehl, Michael Sabranski, Stefan Esser, Daniel Gillor, Markus Müller, Jan Van Lunzen, Timo Wolf, Johannes R. Bogner, Jan Christian Wasmuth, Hildegard Christ, Gerd Fätkenheuer, Christian Hoffmann. (2011) Treatment of AIDS-related Lymphomas (ARL). AIDS1
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Kazuhito Suzuki, Yasuhito Terui, Kenji Nakano, Eriko Nara, Kentaro Nasu, Kyoko Ueda, Noriko Nishimura, Yuko Mishima, Sakura Sakajiri, Masahiro Yokoyama, Shunji Takahashi, Kiyohiko Hatake. (2011) High thymidine kinase activity is a strong predictive factor for poor prognosis in PTCLs treated by CHOP. Leukemia & Lymphoma1-17
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I. N. M. Micallef, M. J. Maurer, G. A. Wiseman, D. A. Nikcevich, P. J. Kurtin, M. W. Cannon, D. G. Perez, G. S. Soori, B. K. Link, T. M. Habermann, T. E. Witzig. (2011) Epratuzumab with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy in patients with previously untreated diffuse large B-cell lymphoma. Blood 118:15, 4053-4061
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N. Schmitz, S. Zeynalova, B. Glass, U. Kaiser, E. Cavallin-Stahl, M. Wolf, M. Haenel, M. Loeffler, L. Truemper, M. Pfreundschuh. (2011) CNS disease in younger patients with aggressive B-cell lymphoma: an analysis of patients treated on the Mabthera International Trial and trials of the German High-Grade Non-Hodgkin Lymphoma Study Group. Annals of Oncology
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Sverker Hasselblom, Martin Stenson, Olle Werlenius, Monica Sender, Catharina Lewerin, Ulrika Hansson, Herman Nilsson-Ehle, Per-Ola Andersson. (2011) Improved outcome for very elderly patients with diff use large B-cell lymphoma in the immunochemotherapy era. Leukemia & Lymphoma1-6
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R. Suzuki, M. Yamaguchi, K. Izutsu, G. Yamamoto, K. Takada, Y. Harabuchi, Y. Isobe, H. Gomyo, T. Koike, M. Okamoto, R. Hyo, J. Suzumiya, S. Nakamura, K. Kawa, K. Oshimi. (2011) Prospective measurement of Epstein-Barr virus DNA in plasma and peripheral blood mononuclear cells of extranodal NK/T-cell lymphoma, nasal type. Blood
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Jia-Jia Huang, Ying-Jie Zhu, Tong-Yu Lin, Wen-Qi Jiang, Hui-Qiang Huang, Zhi-Ming Li. (2011) Beclin 1 expression predicts favorable clinical outcome in patients with diffuse large B-cell lymphoma treated with R-CHOP. Human Pathology 42:10, 1459-1466
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Nihal Martis, Christian Gisselbrecht, Nicolas Mounier. (2011) Quality of life following treatment for B-cell lymphoma. Expert Review of Pharmacoeconomics & Outcomes Research 11:5, 523-532
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Michael Pfreundschuh, Evelyn Kuhnt, Lorenz Trümper, Anders Österborg, Marek Trneny, Lois Shepherd, Devinder S Gill, Jan Walewski, Ruth Pettengell, Ulrich Jaeger, Pier-Luigi Zinzani, Ofer Shpilberg, Stein Kvaloy, Peter de Nully Brown, Rolf Stahel, Noel Milpied, Armando López-Guillermo, Viola Poeschel, Sandra Grass, Markus Loeffler, Niels Murawski. (2011) CHOP-like chemotherapy with or without rituximab in young patients with good-prognosis diffuse large-B-cell lymphoma: 6-year results of an open-label randomised study of the MabThera International Trial (MInT) Group. The Lancet Oncology 12:11, 1013-1022
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Fareed Kow Nanse Arthur, Lawrence Owusu, Francis Agyemang Yeboah, Theresa Rettig, Alex Osei-Akoto. (2011) Prognostic significance of biochemical markers in African Burkitt’s lymphoma. Clinical and Translational Oncology 13:10, 731-736
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Javier Alaba Trueba. (2011) Paciente geriátrica institucionalizada con proptosis en relación con síndrome linfoproliferativo. Revista Española de Geriatría y Gerontología
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Guan-Qun Zhou, Ling-Long Tang, Yan-Ping Mao, Lei Chen, Wen-Fei Li, Ying Sun, Li-Zhi Liu, Li Li, Ai-Hua Lin, Jun Ma. (2011) Baseline Serum Lactate Dehydrogenase Levels for Patients Treated with Intensity-Modulated Radiotherapy for Nasopharyngeal Carcinoma: A Predictor of Poor Prognosis and Subsequent Liver Metastasis. International Journal of Radiation Oncology*Biology*Physics
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R. Alvarez, J. Dupuis, A. Plonquet, C. Christov, C. Copie-Bergman, F. Hemery, I. Gaillard, T. El Gnaoui, F. Kuhnowski, M. Bedoui, K. Belhadj, P. Brugieres, C. Haioun. (2011) Clinical relevance of flow cytometric immunophenotyping of the cerebrospinal fluid in patients with diffuse large B-cell lymphoma. Annals of Oncology
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S. A. M. van de Schans, A. N. M. Wymenga, D. J. van Spronsen, H. C. Schouten, J. W. W. Coebergh, M. L. G. Janssen-Heijnen. (2011) Two sides of the medallion: poor treatment tolerance but better survival by standard chemotherapy in elderly patients with advanced-stage diffuse large B-cell lymphoma. Annals of Oncology
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M. Christina Cox, Vincenzo Ambrogi, Valerio Lanni, Elena Cavalieri, Sabrina Pelliccia, Francesco Scopinaro, Bruno Monarca, Paolo Marchetti, M. Antonietta Aloe Spiriti. (2011) Use of interim [ 18 F]fluorodeoxyglucose-positron emission tomography is not justified in diffuse large B-cell lymphoma during first-line immunochemotherapy. Leukemia & Lymphoma1-7
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Marion J. J. Kuper-Hommel, Maryska L. G. Janssen-Heijnen, Gerard Vreugdenhil, Augustinus D. G. Krol, Hanneke C. Kluin-Nelemans, Jan-Willem W. Coebergh, J. Han J. M. van Krieken. (2011) Clinical and pathological features of testicular diffuse large B-cell lymphoma: a heterogeneous disease. Leukemia & Lymphoma1-5
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Xingchen Wu, Hannu Pertovaara, Pasi Korkola, Martine Vornanen, Hannu Eskola, Pirkko-Liisa Kellokumpu-Lehtinen. (2011) Glucose metabolism correlated with cellular proliferation in diffuse large B-cell lymphoma. Leukemia & Lymphoma1-14
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Simone Oerlemans, Floortje Mols, Marten R. Nijziel, Marnix Lybeert, Lonneke V. Poll-Franse. (2011) The impact of treatment, socio-demographic and clinical characteristics on health-related quality of life among Hodgkin’s and non-Hodgkin’s lymphoma survivors: a systematic review. Annals of Hematology 90:9, 993-1004
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G. Held, N. Murawski, M. Pfreundschuh. (2011) Therapiestrategien beim diffusen großzelligen B-Zell-Lymphom. Der Onkologe 17:9, 789-798
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Naoe Goto, Hisashi Tsurumi, Senji Kasahara, Nobuhiro Kanemura, Takeshi Hara, Ichiro Yasuda, Masahito Shimizu, Nobuo Murakami, Michio Sawada, Toshiki Yamada, Masao Takemura, Mitsuru Seishima, Yusuke Kito, Tsuyoshi Takami, Hisataka Moriwaki. (2011) Serum interleukin-18 level is associated with the outcome of patients with diffuse large B-cell lymphoma treated with CHOP or R-CHOP regimens. European Journal of Haematology 87:3, 217-227
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Yoshizo Kimura, Kensaku Sato, Yutaka Imamura, Fumiko Arakawa, Junichi Kiyasu, Masanori Takeuchi, Hiroaki Miyoshi, Maki Yoshida, Daisuke Niino, Yasuo Sugita, Toshiaki Morito, Tadashi Yoshino, Shigeo Nakamura, Koichi Ohshima. (2011) Small cell variant of mantle cell lymphoma is an indolent lymphoma characterized by bone marrow involvement, splenomegaly, and a low Ki-67 index. Cancer Science 102:9, 1734-1741
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Ranjit S Bindra, Joachim Yahalom. (2011) The important role of radiation therapy in early-stage diffuse large B-cell lymphoma: time to review the evidence once again. Expert Review of Anticancer Therapy 11:9, 1367-1378
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R A Wilcox, K Ristow, T M Habermann, D J Inwards, I N M Micallef, P B Johnston, J P Colgan, G S Nowakowski, S M Ansell, T E Witzig, S N Markovic, L Porrata. (2011) The absolute monocyte and lymphocyte prognostic score predicts survival and identifies high-risk patients in diffuse large-B-cell lymphoma. Leukemia 25:9, 1502-1509
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Kitsada Wudhikarn, C.J. Holman, M. Linan, A.H. Blaes, J.M. Dunitz, M.E. Hertz, B.A. Peterson. (2011) Post-transplant lymphoproliferative disorders in lung transplant recipients: 20-yr experience at the University of Minnesota. Clinical Transplantation 25:5, 705-713
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Brady E. Beltran, Domingo Morales, Pilar Quiñones, L. Jeffrey Medeiros, Roberto N. Miranda, Jorge J. Castillo. (2011) EBV-Positive Diffuse Large B-Cell Lymphoma in Young Immunocompetent Individuals. Clinical Lymphoma Myeloma and Leukemia
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Ellen Burke Beckjord, Neeraj K. Arora, Keith Bellizzi, Ann S. Hamilton, Julia H. Rowland. (2011) Sexual Well-Being Among Survivors of Non-Hodgkin Lymphoma. Oncology Nursing Forum 38:5, E351-E359
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S Hosokawa, J Okamura, Y Takizawa, G Takahashi, K Hosokawa, H Mineta. (2011) Clinical study of mucosa-associated lymphoid tissue lymphomas of the head and neck. The Journal of Laryngology & Otology1-5
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A. A. Alizadeh, A. J. Gentles, A. J. Alencar, C. L. Liu, H. E. Kohrt, R. Houot, M. J. Goldstein, S. Zhao, Y. Natkunam, R. H. Advani, R. D. Gascoyne, J. Briones, R. J. Tibshirani, J. H. Myklebust, S. K. Plevritis, I. S. Lossos, R. Levy. (2011) Prediction of survival in diffuse large B-cell lymphoma based on the expression of 2 genes reflecting tumor and microenvironment. Blood 118:5, 1350-1358
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Jorge J. Castillo, Natalie Sinclair, Dariusz Stachurski, Eric D. Jacobsen. (2011) Positive HIV ELISA test, autoimmune hemolytic anemia, and generalized lymphadenopathy: A unifying diagnosis. American Journal of Hematology 86:8, 690-693
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Eric M. Bessell, Peter Dickinson, Stephen Dickinson, Jennifer Salmon. (2011) Increasing age at diagnosis and worsening renal function in patients with primary central nervous system lymphoma. Journal of Neuro-Oncology 104:1, 191-193
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Brady E. Beltran, Jorge J. Castillo, Domingo Morales, Fernando Hurtado de Mendoza, Pilar Quinones, Roberto N. Miranda, Aly Gallo, Marco Lopez-Ilasaca, James N. Butera, Eduardo M. Sotomayor. (2011) EBV-positive diffuse large B-cell lymphoma of the elderly: A case series from Peru. American Journal of Hematology 86:8, 663-667
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Ying-Jie Zhu, Jia-Jia Huang, Yi Xia, Wei Zhao, Wen-Qi Jiang, Tong-Yu Lin, Hui-Qiang Huang, Zhi-Ming Li. (2011) Primary mediastinal large B-cell lymphoma (PMLBCL) in Chinese patients: clinical characteristics and prognostic factors. International Journal of Hematology 94:2, 178-184
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Celso A. L. De Mello, Victor P. De Andrade, Vladmir C. C. De Lima, Andre L. Carvalho, Fernando A. Soares. (2011) Prognostic impact of MUM1 expression by immunohistochemistry on primary mediastinal large B-cell lymphoma. Leukemia & Lymphoma 52:8, 1495-1503
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Gisèle Compaci, Loic Ysebaert, Lucie Obéric, Hélène Derumeaux, Guy Laurent. (2011) Effectiveness of telephone support during chemotherapy in patients with diffuse large B cell lymphoma: The Ambulatory Medical Assistance (AMA) experience. International Journal of Nursing Studies 48:8, 926-932
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S. Montes-Moreno, N. Martinez, B. Sanchez-Espiridion, R. Diaz Uriarte, M. E. Rodriguez, A. Saez, C. Montalban, G. Gomez, D. G. Pisano, J. F. Garcia, E. Conde, E. Gonzalez-Barca, A. Lopez, M. Mollejo, C. Grande, M. A. Martinez, C. Dunphy, E. D. Hsi, G. B. Rocque, J. Chang, R. S. Go, C. Visco, Z. Xu-Monette, K. H. Young, M. A. Piris. (2011) miRNA expression in diffuse large B-cell lymphoma treated with chemoimmunotherapy. Blood 118:4, 1034-1040
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Rania M. Sami, Aml Soliman Nasr, Noha Y. Ibrahim, Dalia O. Darweesh, Noha M. Hussieny. (2011) Association of IL-10 gene promoter polymorphisms and non-Hodgkin lymphoma in Egyptian patients, relation to susceptibility, correlation with survival. Comparative Clinical Pathology
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Nada Suvajdzic, Predrag Djurdjevic, Milena Todorovic, Maja Perunicic, Roksanda Stojanović, Aleksandra Novkovic, Biljana Mihaljevic. (2011) Clinical characteristics of patients with lymphoproliferative neoplasms in the setting of systemic autoimmune diseases. Medical Oncology
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Dai Chihara, Yasuhiro Oki, Keitaro Matsuo, Hiroshi Onoda, Hirofumi Taji, Kazuhito Yamamoto, Yasuo Morishima. (2011) Incidence and risk factors for central nervous system relapse in patients with diffuse large B-cell lymphoma: analyses with competing risk regression model. Leukemia & Lymphoma1-6
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J. Delabie, H. Holte, J. M. Vose, F. Ullrich, E. S. Jaffe, K. J. Savage, J. M. Connors, L. Rimsza, N. L. Harris, K. Muller-Hermelink, T. Rudiger, B. Coiffier, R. D. Gascoyne, F. Berger, K. Tobinai, W. Y. Au, R. Liang, E. Montserrat, E. P. Hochberg, S. Pileri, M. Federico, B. Nathwani, J. O. Armitage, D. D. Weisenburger. (2011) Enteropathy-associated T-cell lymphoma: clinical and histological findings from the International Peripheral T-Cell Lymphoma Project. Blood 118:1, 148-155
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J Kato, T Mori, K Yokoyama, Y Tsukada, T Ueda, T Shimizu, S Okamoto. (2011) Safety and efficacy of high-dose ranimustine, cytarabine, etoposide and CY (MCVAC) regimen followed by autologous peripheral blood stem cell transplantation for high-risk diffuse large B-cell lymphoma. Bone Marrow Transplantation 46:7, 923-928
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Natacha Heutte, Corinne Haioun, Pierre Feugier, Bertrand Coiffier, Herve Tilly, Christophe Ferme, Jean Gabarre, Franck Morschhauser, Christian Gisselbrecht, Nicolas Mounier. (2011) Quality of life in 269 patients with poor-risk diffuse large B-cell lymphoma treated with rituximab versus observation after autologous stem cell transplant. Leukemia & Lymphoma 52:7, 1239-1248
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