{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T10:36:31Z","timestamp":1792146991180,"version":"4.4.0"},"reference-count":28,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2012,7,4]],"date-time":"2012-07-04T00:00:00Z","timestamp":1341360000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Br J Haematol"],"published-print":{"date-parts":[[2012,9]]},"abstract":"<jats:title>Summary<\/jats:title><jats:p>Diffuse large <jats:styled-content style=\"fixed-case\">B<\/jats:styled-content>\u2010cell lymphoma (<jats:styled-content style=\"fixed-case\">DLBCL<\/jats:styled-content>) occasionally presents with circulating malignant cells. The clinical characteristics and long\u2010term outcomes of these patients have not been described. Twenty\u2010nine newly diagnosed <jats:styled-content style=\"fixed-case\">DLBCL<\/jats:styled-content> presenting in leukaemic phase were identified between 1996 and 2010, at two institutions. Median age was 48\u00a0years, and patients presented with leucocytosis, high lactate dehydrogenase levels, B symptoms, and high International Prognostic Index score. Extra nodal site involvement was observed in all patients and affected the bone marrow (100%), spleen (62%), pleura\/lung (41%), liver (21%), bone (17%), bowels (7%) and cerebrospinal fluid (14%). Blood lymphomatous cells co\u2010expressed <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>19, <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>20, <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>22, <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>38, <jats:styled-content style=\"fixed-case\">CD<\/jats:styled-content>45, <jats:styled-content style=\"fixed-case\">HLA<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">DR<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">FMC<\/jats:styled-content>7 in &gt;90%, and kappa or lambda light chain restriction in &gt;50%. Ninety per cent received rituximab and anthracycline\u2010based chemotherapy. Overall, remission was complete in 54% and partial in 31%; 15% had resistant disease. Median follow\u2010up was 47\u00a0months; 13 (45%) patients remain alive in complete remission. Median progression\u2010free and overall survivals were 11\u00b75 and 46\u00b77\u00a0months, respectively. In summary, patients with <jats:styled-content style=\"fixed-case\">DLBCL<\/jats:styled-content> in leukaemic phase present with high tumour burden and frequent involvement of extra nodal sites. In this uncommon <jats:styled-content style=\"fixed-case\">DLBCL<\/jats:styled-content> subgroup, anthracycline\u2010based regimens with rituximab are associated with early morbidity and mortality, but yield approximately 50% 4\u2010year survival.<\/jats:p>","DOI":"10.1111\/j.1365-2141.2012.09209.x","type":"journal-article","created":{"date-parts":[[2012,7,4]],"date-time":"2012-07-04T23:19:28Z","timestamp":1341443968000},"page":"608-614","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":33,"title":["Characteristics and outcomes of diffuse large <scp>B<\/scp>\u2010cell lymphoma presenting in leukaemic phase"],"prefix":"10.1111","volume":"158","author":[{"given":"Disni","family":"Muringampurath\u2010John","sequence":"first","affiliation":[{"name":"Department of Hematology and Medical Oncology Winship Cancer Institute of Emory University Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David 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USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leon","family":"Bernal\u2010Mizrachi","sequence":"additional","affiliation":[{"name":"Department of Hematology and Medical Oncology Winship Cancer Institute of Emory University Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonard T.","family":"Heffner","sequence":"additional","affiliation":[{"name":"Department of Hematology and Medical Oncology Winship Cancer Institute of Emory University Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morgan","family":"McLemore","sequence":"additional","affiliation":[{"name":"Department of Hematology and Medical Oncology Winship Cancer Institute of Emory University Atlanta GA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan L.","family":"Kaufman","sequence":"additional","affiliation":[{"name":"Department of Hematology and Medical Oncology Winship Cancer Institute of Emory University 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