Factors predicting long‐term survival in low‐risk diffuse large B‐cell lymphoma

Abstract

The International Prognostic Index (IPI) is widely used for risk stratification of patients with diffuse large B-cell lymphoma (DLBCL). However, even among patients with low-risk disease, according to the IPI a substantial proportion of patients ultimately succumb to their disease. Using mature population-based data from the Danish Lymphoma Group, we analyzed if prognostic clinical pretreatment factors could be identified in patients with lowrisk DLBCL. One hundred seventy-seven patients, all with a prognostic profile as favorable as possible according to the IPI and treated with anthracycline-based combination chemotherapy (92%) or loco-regional radiotherapy/surgery (8%) with curative intent were included. The median age was 50 years and 170 achieved complete remission. The median follow-up time was 11 years. Twenty-six patients relapsed, with a median time to relapse of 12.1 months. Overall survival at 5 years and 10 years was 85% and 75%, respectively. Stage II was associated with poor response to treatment (P = 0.044). In a multivariate analysis, Stage II (P = 0.001) and age >50 years (P = 0.043) were independently associated with poor outcome. Patients without these adverse factors had an excellent prognosis, with a survival at 5 and 15 years of 90% and 80%, respectively. In contrast, patients with both adverse factors had poor outcome, with survival at 5 and 15 years of 70% and 29%, respectively (P < 0.001). The present data suggest that risk stratification of DLBCL patients with a favorable IPI score can be improved by the simple use of two clinical pretreatment factors. Am. J.

Clinicopathologic implications of tissue inhibitor of metalloproteinase-1-positive diffuse large B-cell lymphoma

“…In the multivariate survival analysis, older age, the presence of B-symptoms, abnormal serum LDH, more advanced clinical stage (III/IV), and TIMP-1 expression were related to poorer overall survival in the patients with diffuse large B-cell lymphoma. This result is in agreement with those of previous studies of diffuse large B-cell lymphoma using tissue microarray, [59][60][61][62] reflecting the reliability and robustness of our data. Therefore, TIMP-1 expression is an independent factor, and represents a marker for poor prognosis with potential therapeutic implications.…”

Survival in patients with oral and maxillofacial diffuse large B-cell lymphoma

“…This corresponds with the results reported by Møller et al, 22 who also found that age and clinical stage influence the survival of patients with DLBCL. Ho et al 24 also report that the prognosis is influenced by clinical stage and histologic grade because large cell lymphomas are considered aggressive and have a poor prognosis.…”

“…12,20,21 Studies such as that of Møller et al 22 reported the survival of patients with DLBCL without specifying the location of the tumor, and found an overall survival rate of 85% at 5 years, which is much higher than the value determined in this study (45% at 5 years). This may be because in cases in OC- MR, patients often take too long to seek medical attention, which results in more difficult treatment and poorer prognosis.…”

Bone marrow involvement in patients with posttransplant lymphoproliferative disorders: incidence and prognostic factors

“…Bone marrow (BM) examination is an integral part of the Ann Arbor staging system for all lymphoproliferative malignancies [1,2,5]. In non-Hodgkin lymphoma (NHL), Ann Arbor stage III to IV disease is an adverse prognostic feature in the International Prognostic Index [5][6][7][8]. BM involvement by PTLD defines stage IV disease; and similar to immunocompetent patients with NHL, patients with advanced-stage PTLD are known to have inferior prognosis and shorter overall survival [9][10][11][12].…”