Primary cardiac lymphoma: the management and outcome of a single-centre cohort of 22 patients

Authors

  • Xiao-Juan Wei Department of Clinical Oncology, Division of lymphoma, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, P. R. China
  • Hui Yuan Department of Nuclear Medicine, Guangdong Academy of Medical Sciences & Guangdong Provincial People's Hospital, Guangzhou, Guangdong, P. R. China
  • Pek-Lan Khong Department of Diagnostic Radiology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, P. R. China
  • Fen Zhang Department of Pathology, Guangdong Academy of Medical Sciences & Guangdong Provincial People's Hospital, Guangzhou, Guangdong, P. R. China
  • Peng-Jun Liao Department of Haematology, Guangdong Academy of Medical Sciences & Guangdong Provincial People's Hospital, Guangzhou, Guangdong, P. R. China
  • Xin-Miao Jiang Department of Clinical Oncology, Division of lymphoma, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, P. R. China
  • Ling Huang Department of Clinical Oncology, Division of lymphoma, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, P. R. China
  • Han-Guo Guo Department of Clinical Oncology, Division of lymphoma, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, P. R. China
  • Fei-Li Chen Department of Clinical Oncology, Division of lymphoma, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, P. R. China
  • Si-Chu Liu Department of Clinical Oncology, Division of lymphoma, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, P. R. China
  • Yan-Ying Huang Department of Cardiology, Guangdong Academy of Medical Sciences & Guangdong Provincial People's Hospital, Guangzhou, Guangdong, P. R. China
  • Shu-Xia Wang Department of Nuclear Medicine, Guangdong Academy of Medical Sciences & Guangdong Provincial People's Hospital, Guangzhou, Guangdong, P. R. China
  • Wen-Yu Li Department of Clinical Oncology, Division of lymphoma, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, P. R. China

DOI:

https://doi.org/10.1080/0284186X.2021.1950923

Keywords:

Primary cardiac lymphoma, PET/CT with contrast-enhanced CT, single-centre study;, DLBCL

Abstract

Background

The incidence of primary cardiac lymphoma (PCL) is increasing, but the optimal management approach remains unclear. We assessed the clinical characteristics of a single-centre cohort with the goal of determining the optimal management approach. The treatment outcomes and prognostic factors are reported.

Material and methods

All PCL patients were diagnosed via biopsy guided by whole-body imaging (positron emission tomography/computed tomography [PET/CT] and/or contrast-enhanced CT]. Curative therapy involved either surgery or prephase steroids followed by definitive immunochemotherapy, depending on the histological type. The primary outcomes were overall survival (OS) and progression-free survival (PFS); the secondary outcome was the treatment response.

Results

Twenty-two PCL patients (14 males, 8 females; age: 59.5 ± 14.7 years [mean ± S.D.]) were histologically confirmed to have diffuse large B-cell lymphoma (DLBCL; n = 17 [77.3%]), fibrin-associated DLBCL (FA-DLBCL) (n = 4 [18.2%]) and Burkitt lymphoma (n = 1 [4.5%]). Seven patients underwent cardiotomy (three for biopsy, four with curative intent). The median and longest follow-up periods were 16.3 and 180.0 months, respectively. The 16 patients who received curative therapy (complete response [CR], n = 15 [93.8%]; partial response [PR], n = 1 [6.2%]) showed better survival than those who did not (5-year OS: 83.0 ± 11.3% vs. 0%; hazard ratio [HR]: 0.025[95% confidence interval, CI: 0.003–0.187], p < 0.001); 5-year PFS: 78.7 ± 11.0% vs. 0%, HR= 0.010[0.001–0.093], p < 0.001). The left ventricular ejection fractions (LVEF) before and after definitive treatment was 63.6 ± 2.4% and 64.6 ± 4.5%, respectively (p = 0.275, power = 0.318). Extrapericardial lesions were associated with poorer survival (5-year OS: 40.0 ± 29.7% vs. 100%, p = 0.027; 5-year PFS:40.0 ± 21.9% vs. 100%, p = 0.010).

Conclusions

Whole-body imaging is essential for diagnosis and prognosis. Curative therapy provided reasonable outcomes and survival; extrapericardial lesions were associated with a poorer treatment response.

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Published

2021-09-02

How to Cite

Wei, X.-J. ., Yuan, H. ., Khong, P.-L. ., Zhang, F. ., Liao, P.-J. ., Jiang, X.-M. ., … Li, W.-Y. . (2021). Primary cardiac lymphoma: the management and outcome of a single-centre cohort of 22 patients. Acta Oncologica, 60(9), 1122–1129. https://doi.org/10.1080/0284186X.2021.1950923

Issue

Vol. 60 No. 9 (2021): Acta Oncologica

Section

Articles