Primary Testicular Lymphoma:a Single Center Experience and Literature Review

Li, Ling; Zhang, Fangwen; Young, Ken H.; Duan, Wenjing; Li, Zhaoming; Yan, Jiaqin; Fu, Xiaorui; Zhang, Lei; Li, Xin; Sun, Zhenchang; Zhang, Xudong; Chang, Yu; Nan, Feifei; Zhang, Mingzhi

doi:10.1182/blood.V128.22.5415.5415

Abstract

Background: Primary testicular lymphoma (PTL), a rare and aggressive lymphoma mainly affecting the elderly, makes up 1-2% of Non-Hodgkin's lymphomas (NHL). Diffuse large B cell lymphoma (DLBCL) is the most common histological type of PTL. At present, comprehensive management is used for the treatment of PTL, such as operation, chemotherapy and radiotherapy. Although there are multiple treatment methods for PTL, its prognosis is very poor.

Materials and Methods: We retrospectively studied clinical data of 28 patients who were 10 to 82 years old and were diagnosed with PTL between March 2006 and November 2014.The clinical data included clinical characteristic, staging, treatment and outcomes. All of the patients received therapy [rituximab, CHOP (cyclophosphamide, doxorubicin, vincristine and prednisone), intrathecal prophylaxis, or irradiation for the contralateral testis] after orchiectomy. The therapeutic effects were evaluated as complete response (CR), partial response (PR), progressive disease (PD) and stable disease (SD). The prognostic evaluation was based on age, lactic dehydrogenase (LDH), Eastern Cooperative Oncology Group Performance Status (ECOG PS) and staging.

Results: The main clinical features of the 28 patients were shown in Table 1. All patients had testicular mass. Nine patients achieved complete response (CR), 8 patients had partial response (PR), and progressive disease (PD) occurred in 3 patients after 13, 12 and 20 months after treatment, respectively(Table 2). Eight patients died. The median overall survival (OS) was 19.6 months and the median progression-free survival (PFS) was 19.4months(Figure 1,2).

Conclusion: PTL is a highly aggressive disease. Although there are multiple treatment methods for PTL, it readily recurs and its prognosis is very poor. From this study, we can see that age, LDH, ECOG PS and staging are the main factors to affect PFS and OS of the patients with PTL(Table 3).