Evaluation of parameters with potential prognosis impact in patients with primary gastric diffuse large B-cell lymphoma (PG-DLBCL).

BACKGROUND Primary gastric lymphoma is the most common malignancy of the stomach after gastric adenocarcinoma. Most cases are represented by the aggressive histological type (diffuse large B-cell lymphoma). AIM Identification of factors with potential prognosis impact in the aggressive primary gastric lymphoma and the prognosis profile of the patient with impact on the response to therapy and overall survival. PATIENTS AND METHODS The study group is composed of 49 patients diagnosed with primary gastric diffuse large-cell non-Hodgkin's malignant lymphoma at "Fundeni" Hematology Clinic of Bucharest and at the Hematology Clinic of Craiova, Romania, in the period 2005-2010. There were evaluated the following parameters in the attempt to establish correlations between the various studied parameters and the response to treatment, in order to establish the prognosis factors: erythrocyte sedimentation rate (ESR), hemoglobin, serum albumin, serum lactate dehydrogenase (LDH), beta-2 microglobulin, presence of serous infiltration, presence of locoregional adenopathies, bulky tumor, stage of disease, international prognostic index (IPI), quick response to therapy (reduction of >50% in tumor volume after two courses), presence of disease relapses, type of treatment - resection + chemotherapy versus chemotherapy alone, chemotherapy versus chemotherapy + Rituximab. RESULTS We found the following negative prognosis factors: the presence of disease relapse, the value of beta-2 microglobulin higher than 3 mg/dL, the presence of serous infiltration, IPI 3. CONCLUSIONS Identifying prognostic factors is important for personalized therapy approach to obtain optimal response with minimal adverse reaction.