[Primary mediastinal large B-cell lymphoma:a report of 24 cases with literature review].

BACKGROUND OBJECTIVE: Primary mediastinal large B-cell lymphoma (PMBCL) is an uncommon subtybe of diffuse large B-cell lymphoma (DLBCL). This study was to investigate optimal treatment and prognostic factors of PMBCL by analyzing its clinical features. METHODS: Clinical records of 24 PMBCL patients, treated in Fujian Provincial Tumor Hospital from 1995 to 2005, were reviewed. RESULTS: Of the 24 patients, 16 were men and 8 were women, aged from 12 to 81; 20 were at stage Ⅰ-Ⅱ, 1 at stage Ⅲ, and 3 at stage Ⅳ; 13 had bulk disease; 10 had superior vena cava syndrome; 14 had contiguous infiltration; 15 had lacate dehydrogenase elevation; 11 received chemoradiotherapy, 10 received chemotherapy alone, and 3 received radiotherapy alone; 10 achieved complete remission (CR) after scheduled treatment, 12 achieved partial remission (PR), 1 had stable disease and 1 had progressive disease. The median survival time was 89 months; the 3-year overall survival rate was 69%. At the end of follow-up, the patients initially achieved CR were all alive. International prognostic index (IPI) did not predict survival in this analysis, while bulk disease predicted poor survival. CONCLUSIONS: PMBCL has a male dominance in this analysis. Its clinical presentation is critical. Prompt diagnosis is needed. Anthracycline-based chemotherapy with radiotherapy may lead to favorable outcome. The patients with bulk disease have poor survival.