{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T10:59:54Z","timestamp":1773313194313,"version":"3.50.1"},"reference-count":40,"publisher":"Wiley","issue":"17","license":[{"start":{"date-parts":[[2015,6,19]],"date-time":"2015-06-19T00:00:00Z","timestamp":1434672000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2015,9]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Primary splenic diffuse large B\u2010cell lymphoma (PS\u2010DLBCL), an uncommon type of non\u2010Hodgkin lymphoma, has been investigated only in small patient series before the rituximab era. The therapeutic role of splenectomy in addition to immunochemotherapy is unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>The databases of 7 medical centers in Israel were searched for patients diagnosed with PS\u2010DLBCL in 1982\u20102013, and clinical, treatment, and outcome data were collected for 87 patients. The mean patient age was 59.6 years; 57.5% were male.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Patients presented with abdominal pain (81%), B symptoms (59%), splenomegaly (84%), splenic masses (97%), and high lactate dehydrogenase (LDH) levels (84%); 61% had stage I or II disease. The diagnosis was made with core\u2010needle biopsy in 46 patients and with diagnostic splenectomy in 39 patients. Eighty patients (92%) were treated with cyclophosphamide, doxorubicin, vincristine, and prednisone; 68 (78%) received rituximab. A complete response was achieved in 67 patients (77%), and a partial response was achieved in 8 (9%). At 5 years, the overall survival (OS) rate was 77%, and the progression\u2010free survival (PFS) rate was 67%. When patients were stratified by splenectomy at diagnosis, the OS rates were 91% for splenectomized patients and 68% for nonsplenectomized patients (<jats:italic>P<\/jats:italic>\u2009=\u2009.08), and the PFS rates were 85% and 55%, respectively (<jats:italic>P<\/jats:italic>\u2009=\u2009.02). The respective values for the subgroup with early\u2010stage disease were 96% and 63% for OS (<jats:italic>P<\/jats:italic>\u2009=\u2009.009) and 90% and 51% for PFS (<jats:italic>P<\/jats:italic>\u2009=\u2009.01). In a multivariate analysis, a low Eastern Cooperative Oncology Group performance status and splenectomy independently predicted better PFS (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.03).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Patients with PS\u2010DLBCL usually present with abdominal pain, high LDH levels, and a splenic mass. This study shows for the first time that splenectomy at diagnosis improves survival, specifically in patients with early\u2010stage disease. <jats:bold><jats:italic>Cancer<\/jats:italic> 2015;121:2909\u20132916.<\/jats:bold> \u00a9 <jats:italic>2015 American Cancer Society<\/jats:italic>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.29487","type":"journal-article","created":{"date-parts":[[2015,6,20]],"date-time":"2015-06-20T03:46:03Z","timestamp":1434771963000},"page":"2909-2916","source":"Crossref","is-referenced-by-count":42,"title":["Characteristics of primary splenic diffuse large <scp>B<\/scp>\u2010cell lymphoma and role of splenectomy in improving survival"],"prefix":"10.1002","volume":"121","author":[{"given":"Osnat","family":"Bairey","sequence":"first","affiliation":[{"name":"Hematology Institute Rabin Medical Center Petach Tikva Israel"},{"name":"Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lev","family":"Shvidel","sequence":"additional","affiliation":[{"name":"Hematology Institute, Kaplan Medical Center Rehovot Israel"},{"name":"Faculty of Medicine Hebrew University Jerusalem Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chava","family":"Perry","sequence":"additional","affiliation":[{"name":"Sackler Faculty of Medicine Tel Aviv University Tel Aviv Israel"},{"name":"Sourasky Medical Center Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eldad J.","family":"Dann","sequence":"additional","affiliation":[{"name":"Blood Bank and Hematology Institute, Rambam Medical Center Haifa Israel"},{"name":"Ruth and Bruce Rappaport Faculty of Medicine Technion\u2013Israel Institute of Technology Haifa Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosa","family":"Ruchlemer","sequence":"additional","affiliation":[{"name":"Hematology Department Shaare Zedek Medical Center Jerusalem Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tamar","family":"Tadmor","sequence":"additional","affiliation":[{"name":"Ruth and Bruce Rappaport Faculty of Medicine Technion\u2013Israel Institute of Technology Haifa Israel"},{"name":"Hematology Institute, Bnai\u2010Zion Medical Center Haifa Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neta","family":"Goldschmidt","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Hebrew University Jerusalem Israel"},{"name":"Hematology Department Hadassah\u2010Hebrew University Medical Center Jerusalem Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,6,19]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(20010601)91:11<2001::AID-CNCR1225>3.0.CO;2-3"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2010-09-271437"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2011-01-293050"},{"key":"e_1_2_7_5_1","first-page":"947","article-title":"Primary malignant neoplasms of the spleen","volume":"120","author":"Dasgupta T","year":"1965","journal-title":"Surg Gynecol Obstet"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19881001)62:7<1433::AID-CNCR2820620731>3.0.CO;2-V"},{"key":"e_1_2_7_7_1","first-page":"193","article-title":"Primary splenic lymphoma","volume":"30","author":"Isaacson PG","year":"1997","journal-title":"Cancer Surv"},{"key":"e_1_2_7_8_1","first-page":"286","article-title":"Primary splenic lymphoma: does it exist?","volume":"79","author":"Gobbi PG","year":"1994","journal-title":"Haematologica"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000478-200307000-00004"},{"key":"e_1_2_7_10_1","first-page":"1","article-title":"Malignant lymphoma of the spleen. Histological and immunohistochemical studies of morphology and differential diagnosis [in German]","volume":"136","author":"Falk S","year":"1991","journal-title":"Veroff Pathol"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19901215)66:12<2612::AID-CNCR2820661225>3.0.CO;2-Q"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00428-008-0673-y"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.4103\/0377-4929.85080"},{"key":"e_1_2_7_14_1","first-page":"554","article-title":"Primary splenic large B cell lymphoma [in French]","volume":"87","author":"Nfoussi H","year":"2009","journal-title":"Tunis Med"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.humpath.2005.06.005"},{"key":"e_1_2_7_16_1","doi-asserted-by":"crossref","first-page":"e18","DOI":"10.4081\/rt.2010.e18","article-title":"Splenic non\u2010Hodgkin's lymphoma without organomegaly: occult presentation with fatal course and post\u2010mortem diagnosis","volume":"2","author":"Gollard RP","year":"2010","journal-title":"Rare Tumors"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000478-200307000-00005"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19841015)54:8<1606::AID-CNCR2820540823>3.0.CO;2-5"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.3800297"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1081\/CNV-120002492"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.3349\/ymj.2005.46.5.703"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(196604)19:4<461::AID-CNCR2820190402>3.0.CO;2-X"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1827.2012.02844.x"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1989.7.11.1630"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199309303291402"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(87)90171-8"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2007.13.1391"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0080264"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-014-2115-z"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2407-14-153"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2011-04-345256"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kjms.2012.08.025"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0609.2008.01081.x"},{"key":"e_1_2_7_34_1","first-page":"392","article-title":"Chronic hepatitis C infection\u2014eradication of the virus [in Hebrew]","volume":"153","author":"Ben Ari Z","year":"2014","journal-title":"Harefuah"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.leukres.2014.04.009"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19930101)71:1<207::AID-CNCR2820710132>3.0.CO;2-0"},{"key":"e_1_2_7_37_1","first-page":"703","article-title":"Clinical analysis of 3 cases with primary splenic diffuse large B\u2010cell lymphoma [in Japanese]","volume":"52","author":"Tanaka M","year":"2011","journal-title":"Rinsho Ketsueki"},{"key":"e_1_2_7_38_1","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.140.1.59"},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.sult.2006.10.001"},{"key":"e_1_2_7_40_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2014.285"},{"key":"e_1_2_7_41_1","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.49.3228"}],"container-title":["Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fcncr.29487","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fcncr.29487","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/cncr.29487","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T12:56:43Z","timestamp":1760273803000},"score":1,"resource":{"primary":{"URL":"https:\/\/acsjournals.onlinelibrary.wiley.com\/doi\/10.1002\/cncr.29487"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,6,19]]},"references-count":40,"journal-issue":{"issue":"17","published-print":{"date-parts":[[2015,9]]}},"alternative-id":["10.1002\/cncr.29487"],"URL":"https:\/\/doi.org\/10.1002\/cncr.29487","archive":["Portico"],"relation":{},"ISSN":["0008-543X","1097-0142"],"issn-type":[{"value":"0008-543X","type":"print"},{"value":"1097-0142","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,6,19]]}}}