Survival of patients with CD20-negative variants of large B-cell lymphoma: an analysis of the National Cancer Data Base

Abstract

Using records from the National Cancer Data Base, we studied overall survival of CD20-negative variants of diffuse large B-cell lymphoma (DLBCL): primary effusion (PEL, N = 228), plasmablastic (PBL, N = 481), ALK-positive large B-cell (ALK + LBLC, N = 15), and human herpesvirus-8-positive DLBCL (HHV8 + DLBCL, N = 77). Three-year survival was 27% for PEL, 40% for PBL, 34% for ALK + LBCL, and 63% for HHV8 + DLBCL. Compared with unspecified DLBCL, and adjusting for clinical characteristics (including the HIV status), survival was significantly worse for PEL (hazard ratio [HR], 1.58; 95% confidence interval [CI], 1.31–1.90), PBL (HR 1.66; 95% CI, 1.41–1.95), and ALK + LBCL (HR, 2.70; 95% CI, 1.27–5.75), but not for HHV8 + DLBCL (HR, 0.89; 95% CI, 0.54–1.45). The HIV status was not an independent prognostic factor in PEL, PBL, or HHV8 + DLBCL. Advanced stage was prognostic for PBL (p = .0002), but not for ALK + LBCL (p = .96), or HHV8 + DLBCL (p = .28). In PEL and PBL survival significantly differed according to primary site. Novel therapeutic approaches are urgently needed for these rare diseases.

Keywords:

• Diffuse large B-cell lymphoma
• epidemiology
• plasmablastic lymphoma
• primary effusion lymphoma
• ALK-positive large B-cell lymphoma
• multicentric Castleman disease

Acknowledgments

Presented in part at the 58th American Society of Hematology Annual Meeting & Exposition, December 3–6, 2016, San Diego, CA. A. J. O. is supported by the American Society of Hematology Scholar Award. The data used in the study are derived from a de-identified NCDB file. The American College of Surgeons and the Commission on Cancer have not verified and are not responsible for the analytic or statistical methodology employed, or the conclusions drawn from these data by the investigator.

Potential conflict of interest

Disclosure forms provided by the authors are available with the full text of this article online at http://dx.doi.org/10.1080/10428194.2017.1387912.

Funding

This study was conducted using support from authors’ academic departments only.