Диффузная В-крупноклеточная Лимфома С Первичной Локализацией В Яичке

Testicular diffuse large B-cell lymphoma (TDLBCL) is a rare presentation of extranodal lymphoma with poor prognosis and high incidence of CNS and contralateral testis relapses. This study was designed to determine response and outcome of 27 patients with TDLBCL, treated at the N. N. Blokhin Cancer Research Center in 1992-2007. All patients received combined treatment of CHOP, 14 (52 %) had addition rituximab (R-CHOP), intrathecal methotrexate (68 %) and scrotal radiotherapy (44 %). 23 pts (85 %) achieved a complete response (CR), 3-years progression free survival (PFS) was 40 % with median 20 months, overall survival (OS) 57 % with median 48 months. 11 pts experienced a relapse in multiple extranodal sites, 5 of them had CNS and 4 contralateral testis involvement. Addition of rituximab (R-CHOP vs CHOP) improves the outcome CR were 100 and 69 %, 2-y PFS 66 and 35 % respectively. No testicular relapse was observed in patients receiving scrotal radiation. The results showed, that R-CHOP with complete CNS and scrotal prophylaxis improves the outcome of TDLBCL, induce, but not eliminated fully CNS relapse.