scholarly journals Detailed Analysis of Diffuse Large B Cell Lymphoma Patients: A Single-Center, Retrospective Study

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Murat Ozbalak ◽  
M. Cem Ar ◽  
Nukhet Tuzuner ◽  
Ayse Salihoglu ◽  
A. Emre Eskazan ◽  
...  
Keyword(s):  
Retrospective Study ◽  
High Risk ◽  
B Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Young Cohort ◽  
Single Center ◽  
Large B Cell Lymphoma ◽  
The Impact ◽  
Large B Cell

The aim of this single-center, retrospective study was to investigate the impact of rituximab, reconsider the validity of International Prognostic Index (IPI), and evaluate the prognostic role of the cell of origin (CoO) in a relatively young cohort. Three hundred twelve diffuse large B cell lymphoma patients (median age: 52) were included. Rituximab significantly improved the 3- and 5-year progression free survival (PFS) (70% versus 65% and 41% versus 36%, resp.; P<0.001) but led only to a slight, insignificant increase in 3- and 5-year overall survival (OS) (71% versus 77.3% and %67 versus 74.5%, resp.; P=0.264). In the young, low risk patient subgroup (aaIPI = 0&1; n=129), rituximab improved 3- and 5-year PFS and OS rates (P<0.001 and P=0.048, resp.). The efficacy of rituximab in young high risk patients was comparable to the literature. CoO data were available in 190 patients. The OS at 3 years was 79% for GC and 64% for non-GC subgroups (P=0.014). To the best of our knowledge, this is the first study which investigated the impact of R-CHOP in the context of CoO and IPI in a relatively young cohort. CoO was not an independent risk factor for prognosis in the multivariate analysis although patients with GC showed a significant survival advantage in the univariate analysis. CoO was also found to be a significant determinant of response in refractory/relapsed patients. Our results confirm the efficacy of rituximab in low and high risk, young patients outside of a randomized clinical trial setting.

scholarly journals Diffuse large B-cell lymphoma: An institutional analysis

2018 ◽  
Vol 07 (03) ◽  
pp. 200-202 ◽  
Author(s):  
Ajay Gogia ◽  
Chandan K. Das ◽  
Lalit Kumar ◽  
Atul Sharma ◽  
Akash Tiwari ◽  
...  
Keyword(s):  
Retrospective Study ◽  
High Risk ◽  
B Cell ◽  
Response Rate ◽  
Cell Lymphoma ◽  
Prognostic Index ◽  
B Cell Lymphoma ◽  
Cell Of Origin ◽  
Large B Cell Lymphoma ◽  
Large B Cell

Abstract Introduction: Diffuse large B-cell lymphoma (DLBCL) is the most common subtype of non-Hodgkin's lymphoma. We conducted a retrospective study to analyze the clinicopathological characteristics, cell of origin, response to therapy, and the outcome of patients with DLBCL. Materials and Methods: This was a retrospective study which included all patients with DLBCL registered at our center, between May 1, 2013, and July 31, 2015. The data regarding demography, clinical presentation, histopathology, stage, prognostic index, treatment, and treatment-related outcome were collected from prospectively maintained clinical case records of the patients. Results: In the study, we included 267 patients. The median age is 49 (20–81) years with male: female ratio of 2:1. B symptoms were seen in 124 (45%) of patients. Early Stages (I and II) were seen in 130 (52%) patients, while advanced Stages (III and 1V) were seen in 119 (48%) patients. Bulky disease (>7.5 cm) was seen in 30% of cases, and bone marrow was involved in 12%. Extranodal involvement is present in 35% of cases. Cell of origin data was available in 160 (60%) of cases, of which 88 (55%) were germinal center and 72 (45%) were activated B cell in origin. The distribution according to the international prognostic index (IPI) was as follows: low risk 40%, intermediate risk 45%, and high risk in 15%. Rituximab was used in 45% of cases. The overall response rate was 84% with a complete response (CR) rate of 70.5%. The CR rates were better with RCHOP compared with CHOP (77% vs. 61.5%, P = 0.001) and good-risk IPI (83.3% vs. 65.2%, P < 0.001) compared with intermediate- and high-risk IPI. Median follow-up period was 24 months, and 2-year event-free survival (EFS) was 70%. The presence of B symptoms, high IPI, failure to attain CR, poor PS, and nonrituximab-based chemotherapy were significantly associated with lower EFS. Conclusions: This is the first study from India, which investigated the impact of chemotherapy with or without rituximab in context of cell of origin. Adding rituximab to CHOP showed better response rate and EFS irrespective of cell of origin.

scholarly journals Can Body Mass Index Predict the Outcome of Diffuse Large B-Cell Lymphoma? - a Single-Center Retrospective Study in China

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 5400-5400
Author(s):  
Tong Li ◽  
Zhuo-Gang Liu ◽  
Pei-Qi Liang ◽  
Hong-Tao Wang
Keyword(s):  
Body Mass Index ◽  
Retrospective Study ◽  
B Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Primary Response ◽  
Single Center ◽  
Large B Cell Lymphoma ◽  
Large B Cell ◽  
High Bmi

Abstract Body mass index (BMI), as a rough indicator of obesity, has been increasing over the years, along with a high incidence of cardiovascular disease and many malignancies, including diffuse large B-cell lymphoma (DLBCL). However, the predictive prognostic value of BMI at diagnosis for the outcome of DLBCL is controversial. So far, the reported study population has rarely been Chinese. We aimed to assess whether BMI can predict the outcome of Chinese DLBCL patients. We carried out a single-center retrospective study to assess the predictive value of BMI in the outcome of Chinese patients with DLBCL. Among a total of 207 patients who were newly diagnosed with DLBCL in our center between January 2008 and May 2015, 143 eligible patients were enrolled. These patients were stratified into two groups, 74 patients in the low BMI group (BMI<23.0kg/m2)and 69 patients in the high BMI group (BMI≥23.0kg/m2). We compared the baseline characteristics in the low and high BMI groups, and complete remission (CR), partial remission (PR) and progressive disease (PD) as primary response criteria in the two groups. Univariate and multivariate analyses were used to evaluate whether low or high BMI had an impact on progression-free survival (PFS) and overall survival (OS). Well-known influence factors including age, Ca125, B2-microglobulin, international prognostic index, B symptoms, Ann Arbor stage and the use of rituximab were similar between the two groups, while gender was not (P<0.023) but did not act as a risk factor. Besides, drug dose did not vary by BMI. No association between BMI and primary response was observed. Patients in the higher BMI group were inclined to have better OS (p=0.008), but we did not find an association between BMI and PFS (p=0.069). Higher BMI at diagnosis may predict a longer OS, especially for female patients but may not affect the outcome of primary response and PFS. Multi-center and prospective studies are warranted to see if this holds true for the general Chinese DLBCL population, and mechanistic investigations may lead to new treatment options. Disclosures No relevant conflicts of interest to declare.

Efficacy and Safety of Liposomal Cytarabine as Intrathecal Prophylaxis in Patients with Diffuse Large B Cell Lymphoma at High Risk of CNS Involvement: A Multicentric Study Including 80 Patients in Spain.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 1663-1663
Author(s):  
Adolfo de la Fuente ◽  
Antonio Salar ◽  
Carlos Panizo ◽  
Belen Navarro ◽  
Teresa Olave ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Retrospective Study ◽  
High Risk ◽  
B Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Liposomal Cytarabine ◽  
Large B Cell Lymphoma ◽  
Large B Cell

Abstract Abstract 1663 Poster Board I-689 Introduction Lymphomatous meningitis (LM) in patients with Diffuse Large B Cell Lymphoma (DLBCL) is usually an early complication and with poor prognosis. Risk factors have been previously identified for this complication. DepoCyte is an extended released liposomal cytarabine formulation (LC) which has demonstrated better efficacy compared to standard cytarabine for the treatment of LM in one randomized clinical trial. Purpose and Methods A retrospective study was carried out in 24 Spanish sites including patients diagnosed of DLBCL and at risk of LM – defined by the presence of at least one of the following: retroperitoneal mass ≥ 10 cm; Waldeyer ring, sinus, vertebral or bone, and testicular involvement; LDH more than twice the upper normal limit; bone marrow involvement > 30% and serology VIH+. All patients had received LC as IT prophylaxis for LM in the period April 2005 – June 2009. Main endpoints were effectiveness (leptomeningeal involvement rate) and safety of the IT prophylaxis. Results Data from 80 patients were analyzed. Baseline characteristics were: Mean age 55 ± 16 years (range: 18-80 years). Males 74%; Ann Arbor stage IV 54%. All patients received alkylating based regimens, being R-CHOP as the most frequent one (88%). LC was administered as intrathecal prophylactic treatment for LM in all patients. 64 patients completed the IT prophylaxis treatment with a mean of 2,8 ± 0,83 administrations and a median follow up of 17 months (range: 3-40 months) (8 patient still on treatment and 8 patients died before finish prophylaxis). Just one patient (1,6%) had leptomeningeal spread: 76 years old man with primary testicular DLBCL, treated with R-CHOP regime, who did not reach complete response and died after 8 months of follow up due to respiratory failure. Twenty four patients out of eighty (30%) showed adverse events, being headache the most frequent side effect (27%), and 14% grade IV. Headache was reversible in all cases. Chemical arachnoiditis prophylaxis was given to 70 patients. Conclusions This retrospective study has shown that in DLBCL patients and high risk of LM, prophylaxis with LC was feasible and well tolerated. With a median follow up of 17 months (range: 3-40 months) the incidence of LM was 1,6 %. Prospective, randomized comparative studies versus conventional prophylaxis regimes are needed. Disclosures Off Label Use: DepoCyte is an extended released liposomal cytarabine formulation (LC) which has demonstrated better efficacy compared to standard cytarabine for the treatment of LM in one randomized clinical trial. Prphylaxis effectiveness..

Rituximab Improves the Efficacy of High-Dose Chemotherapy With Autograft for High-Risk Follicular and Diffuse Large B-Cell Lymphoma: A Multicenter Gruppo Italiano Terapie Innnovative nei Linfomi Survey

2008 ◽  
Vol 26 (19) ◽  
pp. 3166-3175 ◽  
Author(s):  
Corrado Tarella ◽  
Manuela Zanni ◽  
Michele Magni ◽  
Fabio Benedetti ◽  
Caterina Patti ◽  
...  
Keyword(s):  
High Risk ◽  
B Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Late Relapse ◽  
High Dose ◽  
Refractory Disease ◽  
Large B Cell Lymphoma ◽  
The Impact ◽  
Large B Cell

Purpose To investigate the impact of adding rituximab to intensive chemotherapy with peripheral-blood progenitor cell (PBPC) autograft for high-risk diffuse large B-cell lymphoma (DLB-CL) and follicular lymphoma (FL). Patients and Methods Data were collected from 10 centers associated with Gruppo Italiano Terapie Innnovative nei Linfomi for 522 patients with DLB-CL and 223 patients with FL (median age, 47 years) who received the original or a modified high-dose sequential (HDS) chemotherapy regimen. HDS was delivered to 396 patients without (R−) and to 349 patients with (R+) rituximab; 154 (39%) and 178 patients (51%) in the R− and R+ subsets, respectively, underwent HDS for relapsed/refractory disease. Results A total of 355 R− (90%) and 309 R+ patients (88%) completed the final PBPC autograft. Early treatment-related mortality was 3.3% for R− and 2.8% for R+ (P = not significant). Two parameters significantly influenced the outcome: disease status at HDS, with 5-year overall survival (OS) projections of 69% versus 57% for diagnosis versus refractory/relapsed status, respectively, and rituximab addition, with 5-year OS of 69% versus 60% in the R+ versus R− groups, respectively. In the multivariate analysis, these two variables maintained an independent prognostic value. The marked benefit of rituximab was evident in patients receiving HDS as salvage treatment: the 5-year OS projections for R+ versus R− were, respectively, 64% versus 38%, for patients with refractory disease or early relapse and 71% versus 57%, for patients with late relapse, partial response, or second/third relapse. Conclusion The results of this large series indicate that rituximab should be included in the current practice of PBPC autograft for DLB-CL and FL.

scholarly journals Cell of Origin Impacts Δsuvmax Cutoff for Prediction of Relapse in Patients with Diffuse Large B-Cell Lymphoma

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 23-24
Author(s):  
Carolina Feres ◽  
Leonardo Javier Arcuri ◽  
Larissa LC Teixeira ◽  
Mariana Nassif Kerbauy ◽  
Denise Cunha Pasqualin ◽  
...  
Keyword(s):  
High Risk ◽  
Treatment Failure ◽  
B Cell ◽  
Roc Curve ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Large B Cell Lymphoma ◽  
The Impact ◽  
Large B Cell

Introduction:The role of interim positron emission tomography (PET) as a predictor for progression free survival (PFS) in patients with diffuse large B-cell lymphoma (DLBCL) remains controversial. The incorporation of volumetric and quantitative parameters aims to improve the identification of patients with high risk for treatment failure. Recently, the role of ΔSUVmax, defined as the reduction between the maximum uptake at initial PET and interim-PET (iPET) has been tested as a predictor for PFS. In most studies, a cutoff of 66% reduction successfully identified patients at high risk for treatment failure. We aimed to analyze the role of ΔSUVmax in predicting relapse in a cohort of Brazilian patients with DLBCL, and the impact of COO in this analysis. Methods:We retrospectively analyzed a cohort of patients with DLBCL from Sao Paulo, Brazil. All diagnosis were made by the same hemepathologists, and COO was defined using Hans algorithm. PET scans were obtained at baseline and after 2-3 cycles (iPET) of CHOP-like chemoimmunotherapy. All PET-CTs were read by the same physician, blinded for COO and patient's clinical features. ΔSUVmax was calculated by the difference in % between initial PET SUVmax and iPET. Initially, a cutoff of 66% reduction was used for analysis, but due to low number of patients not achieving a 66% reduction in the activated B-cell (ABC) subgroup, the optimal cutoff was selected based on the ROC curve. ResultsA total of 54 patients were available for analysis. Median age of all patients was 61 years old, and 61% of patients had a germinal center B-Cell (GCB) phenotype. The median maximum uptake at baseline was 31 for the germinal B-cell (GCB) and 34.1 for the activated B-Cell (ABC) phenotype. For all patients, ΔSUVmax &lt;66 was strongly related to relapse (HR=0.065, p=0.0005). In the GCB cohort (n=33), ΔSUVmax &lt;66 was also strongly related to relapse (H=0.02, p=0.0004). In the ABC cohort (n=21), only one patient failed to achieve ΔSUVmax&gt;66. A ROC curve identified a ΔSUVmax&gt;90 as a better cutoff for relapse, and patients not achieving 90% reduction had a higher risk for relapse (p=0.03). MYC/Bcl-2 expression was also compared, and ΔSUVmax &lt;66 was related to events in both double-expressors (DE, p=0.0003) and in non-DE(p=0.036) ConclusionA reduction &lt;66% in SUVmax from baseline PET to iPET was strongly related to the risk of relapse in a cohort of 54 patients with DLBCL. However, the cutoff of 66% was only significant in patients with GCB DLBCL, mostly due to the low number of ABC patients who did not reach a 66% in SUVmax. For ABC patients, a ΔSUVmax&gt;90 improved the identification of patients at high risk for relapse. Larger cohort of patients are needed to validate our exploratory findings. Figure Disclosures No relevant conflicts of interest to declare.

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