Clinical characteristics, treatment patterns and outcomes of patients older than 80 years diagnosed with DLBCL in China over a 10-year period

Shi, Zhan; Tang, Xi; Shen, Qiwei; Chen, Jiayan; Liu, Fei; Chen, Xi; Wang, Jingwen; Zhuang, Jie

doi:10.1007/s00280-019-03859-6

Cited by 3 publications

(15 citation statements)

References 43 publications

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“…Older age is an adverse prognostic factor that correlates with inferior survival in DLBCL (29,30). Like previous studies, the present study showed that age was an independent prognostic factor of DLBCL patients (PFS: HR =3.330, P<0.001; OS: HR =3.661, P<0.001, respectively).…”

Section: Low Risk N=29supporting

confidence: 83%

Value of total lesion glycolysis and cell-of-origin subtypes for prognostic stratification of diffuse large B-cell lymphoma patients

Jiang¹,

Teng²,

Zheng³

et al. 2021

Quant Imaging Med Surg

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Background: This study aimed to explore the added prognostic value of baseline metabolic volumetric parameters and cell of origin subtypes to the National Comprehensive Cancer Network International Prognostic Index (NCCN-IPI) in nodal diffuse large B-cell lymphoma (DLBCL) patients.Methods: A total of 184 consecutive de novo nodal DLBCL patients who underwent baseline positron emission tomography/computed tomography (PET/CT) were included in this study. Kaplan-Meier estimates were generated to evaluate the clinical, biological, and PET/CT parameters' prognostic value. The Cox proportional hazards model was performed to examine the potential independent predictors for progressionfree survival (PFS) and overall survival (OS).Results: With a median follow-up of 35 months, the 3-year PFS and OS were 65.2% and 73.0%, respectively. In univariate analysis, total lesion glycolysis (TLG), cell-of-origin subtypes, and NCCN-IPI were both PFS and OS predictors. High TLG (≥1,852), non-germinal center B (non-GCB), as well as high NCCN-IPI (≥4), were shown to be independently significantly associated with inferior PFS and OS after multivariate analysis. Based on the number of risk factors (high TLG, non-GCB, and high NCCN-IPI), a revised risk model was designed, and the participants were divided into four risk groups with very different outcomes, in which the PFS rates were 89.7%, 66.2%, 51.7%, and 26.7% (χ 2 =30.179, P<0.001), and OS rates were 93.1%, 73.8%, 56.7%, and 43.3%, respectively (χ 2 =23.649, P<0.001), respectively. Compared with the NCCN-IPI alone, the revised risk model showed a stronger ability to reveal further discrimination among subgroups, especially for participants with very unfavorable survival outcomes (PFS: χ 2 =9.963, P=0.002; OS: χ 2 =4.166, P=0.041, respectively). Conclusions:The TLG, cell-of-origin subtypes, and NCCN-IPI are independent prognostic survival factors in DLBCL patients. Moreover, the revised risk model composed of the number of risk factors (high TLG, non-GCB, and high NCCN-IPI) can stratify patients better than the NCCN-IPI, especially for patients at high risk, which suggests its potential integration into decision making for personalized medicine.

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Section: Low Risk N=29supporting

confidence: 83%

Value of total lesion glycolysis and cell-of-origin subtypes for prognostic stratification of diffuse large B-cell lymphoma patients

Jiang¹,

Teng²,

Zheng³

et al. 2021

Quant Imaging Med Surg

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“…In this study treatment‐related mortality (TRM) was 8.5%. Comparable results are reported by Shi et al among 57 patients treated with R‐mini‐CHOP; CR was 60%, with a 2‐year OS of 74.3%, a PFS of 70.9%, and a TRM of 3.5% 14 . Oliveri et al 17 had worse results in a subgroup of 15 frail patients (group III) with a median age of 81, treated with mini‐CHOP without rituximab, and CR rate was only 26.3%, with an elevated TRM of 20%.…”

Section: Resultssupporting

confidence: 63%

“…Studies show a survival improvement in selected patients treated with R-mini-CHOP, with in prospective cohorts an OS at 2 years of 59%-74.3%. 13,14 Less intensive treatments without anthracyclines have worse results, with a decrease in OS and PFS. 15,16 In frail populations, oral chemotherapy can also increase survival and should be considered, due to the poor prognosis without specific treatment, with a median survival of a few months.…”

Section: Discussionmentioning

confidence: 99%

“…Four prospective studies (with a total of 221 patients) evaluated chemoimmunotherapy with anthracycline, and mean number of patients was 55 (9-140). 13,14,17,18 Peyrade et al 13 In retrospective studies, information on standard treatment outcomes was available in 14 studies (2409 patients), and population ranged from 9 to 651 patients. 19,20,22,25,27,29,30,[32][33][34]36,37,40,44 The main results on efficacy, survival, and toxicity were in the same range than prospective cohort for patients receiving standard treatment.…”

Section: Standard Treatmentmentioning

confidence: 99%

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Impact of therapeutic management and geriatric evaluation on patient of eighty years and older with diffuse large B‐cell lymphoma on survival: A systematic review

Briand

Gérard

Gauthier

et al. 2021

European J of Haematology

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Diffuse large B cell lymphoma (DLBCL) represents 30%-40% of adult non-Hodgkin lymphoma (NHL). 1 DLBCL is a highly aggressive disease, with a limited life expectancy without treatment and a poor prognosis in case of relapse or refractory disease. 2 Its incidence increases with age, with a median age of 70 years at diagnosis. 1 Considering population aging, an increased incidence is expected within the next few years. 3 R-CHOP (Rituximab, Cyclophosphamide, Doxorubicin, Oncovin, Prednisone) regimen is widely used as a first-line treatment for this

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“…Previous studies have reported a few rules regarding the date of rituximab infusion in an R-CHOP or R-CHOP-like regimen. Rituximab was administered on the same day of the CHOP regimen in key studies [19][20][21], and in several studies, rituximab was administered on the day before the CHOP or CHOP-like regimen [22][23][24][25][26][27]; in some studies, rituximab infusion was acceptable on both of the aforementioned ways [28][29][30]. Various reasons in practice might influence the manipulation of the rituximab-containing regimen.…”

Section: Discussionmentioning

confidence: 99%

Bone Marrow Infiltration Is a Distinctive Risk Factor for Rituximab Infusion-Related Reactions in CD20-Positive B-Cell Non-Hodgkin Lymphoma

Ohata

Takenaka

Sugiyama

et al. 2022

Advances in Hematology

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Background. Bone marrow infiltration of lymphoma cells is a candidate risk factor for infusion-related reactions (IRRs) in patients with CD20-positive B-cell non-Hodgkin lymphoma (B-NHL). However, despite with the lack of sufficient data, the effect of bone marrow infiltration of B-NHL cells on the incidence rate of grade 2 or higher IRRs with the administration of rituximab has been retrospectively studied in this paper. Methods. Patients with CD20-positive B-NHL who received the rituximab induction therapy for the first time were enrolled in this study. To evaluate the bone marrow infiltration of B-NHL cells, May–Giemsa stain of bone marrow films and flow cytometry examination of bone marrow aspiration samples were performed. IRR grade was determined using the IRR criteria in the Common Terminology Criteria for Adverse Events version 4.0. Results. A total of 127 patients were eligible for this study. Grade 2 or higher IRRs were observed in 43 (34%) patients. In univariate analysis, use of glucocorticoid before rituximab infusion was a strong risk-avoiding factor for grade 2 or higher IRRs. Advanced stage of disease (Ann Arbor: stages III and IV) or bone marrow infiltration of B-NHL cells revealed the risk factors, regardless of glucocorticoid premedication. Using multivariate analysis, bone marrow infiltration was found to be an independent risk factor for patients without prior glucocorticoid use. Conclusion. Bone marrow infiltration of B-NHL cells is a risk factor for grade 2 or higher IRRs at the first rituximab induction therapy without glucocorticoid premedication.

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Clinical characteristics, treatment patterns and outcomes of patients older than 80 years diagnosed with DLBCL in China over a 10-year period

Cited by 3 publications

References 43 publications

Value of total lesion glycolysis and cell-of-origin subtypes for prognostic stratification of diffuse large B-cell lymphoma patients

Value of total lesion glycolysis and cell-of-origin subtypes for prognostic stratification of diffuse large B-cell lymphoma patients

Impact of therapeutic management and geriatric evaluation on patient of eighty years and older with diffuse large B‐cell lymphoma on survival: A systematic review

Bone Marrow Infiltration Is a Distinctive Risk Factor for Rituximab Infusion-Related Reactions in CD20-Positive B-Cell Non-Hodgkin Lymphoma

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