Diffuse large B-cell lymphoma with primary treatment failure: Ultra-high risk features and benchmarking for experimental therapies. Am J Hematol 2017 Feb;92(2):161-170
Date
11/24/2016Pubmed ID
27880984Pubmed Central ID
PMC5549936DOI
10.1002/ajh.24615Scopus ID
2-s2.0-85009832242 (requires institutional sign-in at Scopus site) 64 CitationsAbstract
The outcomes of patients with DLBCL and primary treatment failure (PTF) in the rituximab era are unclear. We analyzed 331 patients with PTF, defined as primary progression while on upfront chemoimmunotherapy (PP), residual disease at the end of upfront therapy (RD) or relapse < 6 months from end of therapy (early relapse; ER). Median age was 58 years and response to salvage was 41.7%. Two-year OS was 18.5% in PP, 30.6% in RD and 45.5% in ER. The presence of PP, intermediate-high/high NCCN-IPI at time of PTF or MYC translocation predicted 2-year OS of 13.6% constituting ultra-high risk (UHR) features. Among the 132 patients who underwent autologous hematopoietic cell transplantation, 2-year OS was 74.3%, 59.6% and 10.7% for patients with 0,1 and 2-3 UHR features respectively. Patients with PTF and UHR features should be prioritized for clinical trials with newer agents and innovative cellular therapy.
Author List
Costa LJ, Maddocks K, Epperla N, Reddy NM, Karmali R, Umyarova E, Bachanova V, Costa C, Glenn MJ, Chavez JC, Calzada O, Lansigan F, Nasheed H, Barta SK, Zhou Z, Jaglal M, Chhabra S, Hernandez-Ilizaliturri F, Xavier AC, Mehta A, Peker D, Forero-Torres A, Al-Mansour Z, Evens AM, Cohen JB, Flowers CR, Fenske TS, Hamadani MAuthor
Mehdi H. Hamadani MD Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AgedAntineoplastic Combined Chemotherapy Protocols
Benchmarking
Disease Progression
Disease-Free Survival
Hematopoietic Stem Cell Transplantation
Humans
Lymphoma, Large B-Cell, Diffuse
Middle Aged
Multivariate Analysis
Neoplasm, Residual
Recurrence
Retrospective Studies
Risk Factors
Salvage Therapy
Transplantation, Autologous
Treatment Failure
