Thanh Tung Nguyen

This study evaluated clinical characteristics, treatment outcomes, and CNS relapse patterns in patients with breast-involved diffuse large B-cell lymphoma (DLBCL), a rare extranodal presentation with limited real-world data. We conducted a retrospective study on 33 consecutive patients with newly diagnosed breast-involved DLBCL treated from 2019 to 2024. All patients received R-CHOP. Baseline CNS screening—including neurological examination, fundoscopy, brain magnetic resonance imaging (MRI), and cerebrospinal fluid (CSF) analysis—was routinely performed. High-dose methotrexate (HD-MTX) was offered as CNS prophylaxis after completion of systemic therapy based on multidisciplinary team evaluation and clinician–patient shared decision-making according to institutional treatment protocols. Median age was 52.6 years; 84.8% had ECOG 0. Non-GCB subtype predominated (84.8%), and Ki-67 >70% was present in 69.7%. The overall response rate was 90.9%, with 84.8% complete responses. At a median follow-up of 44 months, 5-year Overall Survival (OS) and Progression-Free Survival (PFS) were 84.8% and 66.7%. CNS relapse occurred in 4 of 6 patients (66.7%) without prophylaxis, all within 5–11 months after R-CHOP, whereas no CNS relapses were observed among prophylaxis recipients (p < 0.001), although this observation should be interpreted with extreme caution given the very small non-prophylaxis subgroup (n = 6), limited statistical power, and non-randomized treatment allocation. Exploratory analyses suggested that bulky disease was associated with inferior OS. R-CHOP achieved high response rates and favorable long-term outcomes in breast-involved DLBCL. The absence of CNS relapse among HD-MTX prophylaxis recipients, contrasted with a high relapse rate in those without prophylaxis, provides only a hypothesis-generating observation that requires confirmation in larger prospective studies; this warrants further investigation of the role of systemic CNS prophylaxis.

Introduction: Extranodal natural killer/T-cell lymphoma, nasal type (ENKTL-NT), is a rare and aggressive lymphoma for which real-world data from resource-limited settings remain scarce. This study evaluated the efficacy and safety of frontline multimodal treatment strategies for localized ENKTL-NT. Methods: We retrospectively analyzed 62 patients with localized ENKTL-NT treated at the Vietnam National Cancer Hospital between May 2019 and June 2025. Patients received concurrent chemoradiotherapy followed by VIPD or VIDL, or sequential chemoradiotherapy with GELOX/PGEMOX. Treatment responses, survival outcomes, and toxicities were assessed. Results: The median age was 44 years, and 67.7% of patients had stage I disease. Baseline EBV-DNA positivity was detected in 46.8%, while 54.8% had PINKE scores of 1–2. The overall response rate was 93.5%, including an 85.5% complete response rate. Grade 3–4 neutropenia was the most common adverse event (18.7%). The estimated 3-year progression-free survival (PFS) and overall survival (OS) rates were 76.3% and 79.5%, respectively. Multivariable Cox analysis identified PINKE risk stratification as an independent predictor of both PFS and OS. Conclusions: Frontline multimodal treatment strategies achieved high response rates, favorable survival outcomes, and manageable toxicities in localized ENKTL-NT. The PINKE score remained an important prognostic factor, supporting risk-adapted treatment selection in routine clinical practice.

Introduction: to evaluate clinical characteristics, treatment patterns, treatment responses, and survival outcomes of patients with ocular adnexal MALT lymphoma treated in Vietnam. Methods: this single-center retrospective observational study included adult patients with newly diagnosed ocular adnexal MALT lymphoma treated at the Vietnam National Cancer Hospital between January 2019 and December 2024. Treatment strategies comprised watchful waiting, radiotherapy, doxycycline, rituximab monotherapy, or rituximab-based chemoimmunotherapy. Treatment response was assessed according to the Lugano classification. Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan-Meier method. Results: a total of 68 patients were included, with a median age of 60 years and male predominance. Most patients presented with early-stage disease and low MALT International Prognostic Index risk. Initial management consisted of active surveillance in 33.8% of patients and active treatment in 66.2%, most commonly doxycycline or rituximab-based therapy. Among patients receiving rituximab-based combination chemotherapy, interim assessment demonstrated a 100% overall response rate. At the end of treatment, the overall response rate among treated patients was 75.6%, including 37.8% complete responses. After a median follow-up of 32 months, median PFS was not reached, with an estimated 3-year PFS of 85.3% and a 3-year OS of 97%. No statistically significant difference in PFS was observed between patients managed with immediate treatment and those initially observed. Conclusion: ocular adnexal MALT lymphoma in this Vietnamese cohort demonstrated indolent clinical behaviour, high treatment responsiveness, and excellent survival outcomes. Both active surveillance and active treatment were associated with favourable progression-free and overall survival when appropriately applied. These findings provide region-specific evidence to inform individualised management strategies in Vietnam.

Introduction: This single-center retrospective study aimed to assess the efficacy and safety of first-line rituximab-containing regimens in treatment-naïve patients with mantle cell lymphoma (MCL) in a resource-constrained setting. Methods: We included 73 patients diagnosed with MCL between May 2019 and June 2024 who received rituximab-based chemotherapy (RB, RBAC, RDHAP, or RCHOP) at the Vietnam National Cancer Hospital. Clinical characteristics, treatment responses, survival outcomes, and prognostic factors were analyzed. Results: The median age was 60 years, and the male-to-female ratio was 2.17. Stage IV disease was present in 47.9% of patients and stage III in 38.4%. B symptoms were observed in 27.4%, and Ki-67 >30% in 45.2% of patients. The overall response rate (ORR) was 94.5%, including a complete response rate of 64.4%. The most common grade 3/4 adverse event was neutropenia (17.8%). The 3-year progression-free survival (PFS) and overall survival (OS) rates were 72.6% and 93.2%, respectively. Mantle Cell Lymphoma International Prognostic Index (MIPI) risk classification, treatment response, and extranodal involvement were associated with PFS, whereas OS was primarily influenced by treatment response. Conclusion: Rituximab-based chemotherapy appears to provide favorable efficacy and manageable toxicity in Vietnamese patients with MCL. These findings suggest that such regimens may remain a feasible first-line option in settings with limited access to novel agents and advanced supportive care.