Cd20-negative diffuse large b-cell lymphoma subtype: a look at texas cancer registry

Abstract

Introduction CD20-negative diffuse large B-cell lymphoma (DLBCL) histologic subtypes are rare and aggressive lymphomas. As these lymphomas are rare, most epidemiology and survival information is derived from case reports and case series. The main objective of this research was to estimate CD20-negative DLBCL survival and compare it to CD20-positive DLBCL survival. Methods We retrospectively queried incidence files of the Texas Cancer Registry from 1995-2017 for 4 histologic subtypes of CD20-negative DLBCL: primary effusion lymphoma, plasmablastic lymphoma, ALK-positive large B-cell lymphoma and Large B-cell lymphoma arising in HHV8 (human herpesvirus-8). The Kaplan-Meier method was used to estimate survival. Survival between CD20-negative and CD20-positive DLBCL (mediastinal large B-cell lymphoma, malignant lymphoma, DLBCL, NOS , malignant lymphoma, DLBCL, immunoblastic, NOS, T-cell/histiocyte-rich large B-cell lymphoma and intravascular large B-cell lymphoma) was compared using a log-rank test. Results A total of 199 CD20-negative cases were identified. Eighty-three percent were males and 17% females. Twenty-seven patients were HIV-positive (78% had plasmablastic lymphoma). Ninety-seven were non-Hispanic Caucasians, 32 African-American, 67 were Hispanic and 3 were of another race. Most patients present with distant disease (62.28%), followed by localized disease (25.75%) and 11.98% had regional disease. Median age at diagnosis was 51 years, which was younger compared to 66 years for CD20-positive DLBCL. Forty percent of patients resided in areas with high poverty (poverty index ≥20%), compared to only 30% for CD20-positive DLBCL. Sixty-two percent received chemotherapy for treatment, of which 87% received multi-agent chemotherapy. Seven percent received radiation as part of treatment. At median follow up of 33 months, median overall survival of CD20-negative DLBCL was 15 months vs 57 months for CD20-positive DLBCL. Conclusion CD20-negative DLBCL histologic subtypes have poor prognosis compared to CD20-positive DLBCL subtypes. Compared to CD20-positive DLBCL, patients at presentation were younger and were more likely to have distant disease.