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What is bulky disease in Diffuse Large B-cell Lymphoma?

By May 13, 2008

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The importance of having a large lymph node mass in non-Hodgkin's lymphoma (NHL) has been known for a long time. The larger the largest node mass, the worse the outcomes after treatment. But what is the best cutoff for terming a node mass as 'bulky'? There are a few different definitions of 'bulky' disease - 10 cm and 5 cm are the most commonly used. The best is a matter of debate.

Researchers from Switzerland went through a large database of young patients with diffuse large B-cell non-Hodgkin's lymphoma (DLBCL). They found that any size cutoff between 5 cm and 10 cm makes a significant difference in how fast a patient relapses, and how long he lives. The addition of rituximab to CHOP chemotherapy reduces the impact of large masses, but still those who had masses more than 10 cm did worse in every aspect, including the survival after treatment.

In the current era of treatment with rituximab, it seems that 10 cm is the best cutoff value for differentiating paients with 'bulky' and 'nonbulky' disease.

Comments
May 19, 2008 at 1:07 pm
(1) Harvey says:

I had Large B Cell non Hodgkins lymphoma THREE TIMES. In 2001 masses in spleen,lower left abdominal 14cm x6cm,(rituximab only) 2005, left arm and shoulder 5cm,(radiation only), 2007, masses(11cm x 9c) between the translpant. kidney and the lateral side of the inferior vena cava and right iliac artery.R-CHOP)
I have been in remission with all three. Also, I had Renal cell Carcinoma cancer,lost both Kidney`s, 1983,noma in right forarm, 2006(surgical removed).
I had kidny transplant 1999, ans was removed from all immunesuppressant drugs except 5mg Prednisone(1.1 creatinine), which I continue today.
My question is does the transplant kidney have effect on my immune system to cause my Lymphoma?

harveycopeland@charter.net

May 21, 2008 at 11:23 am
(2) Indranil Mallick - About.com Guide to Lymphoma says:

Yes, your NHL could well be realted to your kidney transplant. There is an increased risk of NHL after transplants because drugs used after transplant to prevent a rejection supress the immune system. Follow the link for the article on NHL after organ transplantation.

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