Diffuse Large B-Cell Lymphoma (Non-Hodgkin Lymphoma) Staging
No Results
No Results
processing….
Systems for staging diffuse large B-cell lymphoma (DLBCL) are provided below, including the World Health Organization (WHO)/Revised European American Classification of Lymphoid Neoplasms (REAL) system [1, 2] and the Cotswolds modification of the Ann Arbor system. Risk stratification with the International Prognostic Index (IPI) score is also provided. [3]
DLBCL, not otherwise specified (NOS):
T-cell/histiocyte rich large B-cell lymphoma
Primary DLBCL of the central nervous system (CNS)
Primary cutaneous DLBCL, leg type
Epstein-Barr virus (EBV)-positive DLBCL of the elderly
Germinal center B-cell (GCB)-DLBCL*
Activated B-cell (ABC)-DLBCL*
DLBCL associated with chronic inflammation:
Primary mediastinal lymphoma
Intravascular large B-cell lymphoma
Anaplastic lymphoma kinase (ALK)-positive large B-cell lymphoma
* These 2 types of lymphoma are not yet recognized by the WHO 2008 classification. However, they are distinct subtypes of DLBCL on the basis of the cell of origin and represent distinct variants of DLBCL, with different biologies and clinical prognoses. [2]
Table. Cotswolds modification of Ann Arbor staging system (Open Table in a new window)
Stage
Area of Involvement
I
Single lymph node group
II
Multiple lymph node groups on same side of diaphragm
II
Multiple lymph node groups on both sides of diaphragm
IV
Multiple extranodal sites or lymph nodes and extranodal disease
X
Bulk > 10 cm
E
Extranodal extension or single isolated site of extranodal disease
A/B
B symptoms: weight loss > 10%, fever, drenching night sweats
Factors (1 point for each factor present):
Age ≥ 60y
Eastern Cooperative Oncology Group (ECOG) performance status ≥ 2
Elevated lactate dehydrogenase (LDH)
Ann Arbor stage III or IV
≥ 2 extranodal sites of disease
Risk category (factors):
Low (0 or 1)
Low-intermediate (2)
High-intermediate (3)
High (4 or 5)
Jaffe ES. The 2008 WHO classification of lymphomas: implications for clinical practice and translational research. Hematology Am Soc Hematol Educ Program. 2009. 523-31. [Medline].
National Comprehensive Cancer Network. NCCN Clinical Practice Guidelines in Oncology: Non-Hodgkin’s Lyphomas. Version 1.2016. Accessed: December 31, 2015.
A predictive model for aggressive non-Hodgkin’s lymphoma. The International Non-Hodgkin’s Lymphoma Prognostic Factors Project. N Engl J Med. 1993 Sep 30. 329(14):987-94. [Medline].
Stage
Area of Involvement
I
Single lymph node group
II
Multiple lymph node groups on same side of diaphragm
II
Multiple lymph node groups on both sides of diaphragm
IV
Multiple extranodal sites or lymph nodes and extranodal disease
X
Bulk > 10 cm
E
Extranodal extension or single isolated site of extranodal disease
A/B
B symptoms: weight loss > 10%, fever, drenching night sweats
Francisco J Hernandez-Ilizaliturri, MD Professor of Medicine, Department of Medical Oncology, Associate Professor of Immunology, Department of Immunology, Chief, Lymphoma and Myeloma Section, Director, The Lymphoma Translational Research Program, Roswell Park Cancer Institute, University of Buffalo State University of New York School of Medicine and Biomedical Sciences
Francisco J Hernandez-Ilizaliturri, MD is a member of the following medical societies: American Association for Cancer Research, American Society of Hematology
Disclosure: Nothing to disclose.
Jasmeet Anand, PharmD, RPh Adjunct Instructor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference
Disclosure: Nothing to disclose.
Christopher D Braden, DO Hematologist/Oncologist, Chancellor Center for Oncology at Deaconess Hospital; Medical Director, Deaconess Hospital Outpatient Infusion Centers; Chairman, Deaconess Hospital Cancer Committee
Christopher D Braden, DO is a member of the following medical societies: American Society of Clinical Oncology, American Society of Hematology
Disclosure: Nothing to disclose.
Koyamangalath Krishnan, MD, FRCP, FACP Dishner Endowed Chair of Excellence in Medicine, Professor of Medicine, James H Quillen College of Medicine at East Tennessee State University
Koyamangalath Krishnan, MD, FRCP, FACP is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians-American Society of Internal Medicine, American Society of Hematology, Royal College of Physicians
Disclosure: Nothing to disclose.
Diffuse Large B-Cell Lymphoma (Non-Hodgkin Lymphoma) Staging
Research & References of Diffuse Large B-Cell Lymphoma (Non-Hodgkin Lymphoma) Staging |A&C Accounting And Tax Services
Source
0 Comments