Contributions
Abstract: PB1457
Type: Publication Only
Session title: Aggressive Non-Hodgkin lymphoma - Clinical
Background
Relapse/refractoriness (R/R) in diffuse large cell B lymphomas (DLBCL) and high grade (HG- DLBCL) affects more than 1/3 of patients and the existence of a poor prognosis poor prognosis and therapeutic challenge is well known.
Aims
This unicentric retrospective analysis aims to describe the response to 1st-line treatment and relapse of patients with DLBCL and HG- DLBCL.
Methods
Retrospective analysis of DLBCL or HG- DLBCL patients diagnosed and treated at a center between 2015 and 2019. We identified 125 with the diagnosis of DLBCL or HG- DLBCL between 2015-2019. Among this group, 58 did not undergo in curative chemoimmunotherapy (CIT). We report the results of a statistic analysis.
Results
The DLBCL group comprised 47 patients (81%), 13% G- DLBCL (13%) and 6% PTLD; 9% with involvement of extranodal sites. 55% were men; median age of 61 years (52% >60 years); 10% with ECOG ≥2. 10% were HIV+. The International Prognostic Index (IPI) was calculated: low: 26%; low intermediate: 30%; high intermediate: 33%; high: 7%.
The CIT schemes were R-CHOP (n=44), R-CNOP (n=10), R-mini-CHOP (n=8), others (n=5). The dose/replacement adjustment of anthracycline was made in patients aged > 60 years, high ECOG and/or comorbidities. 25% were treated with radiotherapy alone. 67% achieved complete response (CR).
R/R was 44.8% (recurrence n=10; refractoriness n=20). The median time to relapse was 10.5 months. At diagnosis these patients had IPI ≥2 in 87%, mass >7cm in 50% and 73% were CD5+. The activated B Cell subtype was identified in 1/3 of the cases. Five were double/triple-expressor and two double-hit.
Twenty-four patients underwent in second-line therapies. Only 29% (n=7) achieved CR (R-ICE n=3; R-DHAP n=2; R-Bendamustine n=1; CVP n=1). Four patients underwent autotransplantation. Eight performed ≥3 therapeutic lines.
The median follow-up was 19.3 months. The mortality rate was 36%. 71% died from disease progression. The median overall survival of patients undergoing 1st CIT was 39 months.
Conclusion
By advanced age, commorbidities and/or high ECOG, only 54% of patients with DLBCL or HG- DLBCL were elected to curative CIT. Of the remaining, only 9 are alive with follow-up time ≥ 18 months. The patients studied presented characteristics, risk factors and unsatisfactory responses to CIT in R/R, as described in the literature. Thus, we emphasize the need for therapeutic strategies adapted to improve prognosis.
Keyword(s): Diffuse large B cell lymphoma, Relapsed lymphoma, Treatment
Abstract: PB1457
Type: Publication Only
Session title: Aggressive Non-Hodgkin lymphoma - Clinical
Background
Relapse/refractoriness (R/R) in diffuse large cell B lymphomas (DLBCL) and high grade (HG- DLBCL) affects more than 1/3 of patients and the existence of a poor prognosis poor prognosis and therapeutic challenge is well known.
Aims
This unicentric retrospective analysis aims to describe the response to 1st-line treatment and relapse of patients with DLBCL and HG- DLBCL.
Methods
Retrospective analysis of DLBCL or HG- DLBCL patients diagnosed and treated at a center between 2015 and 2019. We identified 125 with the diagnosis of DLBCL or HG- DLBCL between 2015-2019. Among this group, 58 did not undergo in curative chemoimmunotherapy (CIT). We report the results of a statistic analysis.
Results
The DLBCL group comprised 47 patients (81%), 13% G- DLBCL (13%) and 6% PTLD; 9% with involvement of extranodal sites. 55% were men; median age of 61 years (52% >60 years); 10% with ECOG ≥2. 10% were HIV+. The International Prognostic Index (IPI) was calculated: low: 26%; low intermediate: 30%; high intermediate: 33%; high: 7%.
The CIT schemes were R-CHOP (n=44), R-CNOP (n=10), R-mini-CHOP (n=8), others (n=5). The dose/replacement adjustment of anthracycline was made in patients aged > 60 years, high ECOG and/or comorbidities. 25% were treated with radiotherapy alone. 67% achieved complete response (CR).
R/R was 44.8% (recurrence n=10; refractoriness n=20). The median time to relapse was 10.5 months. At diagnosis these patients had IPI ≥2 in 87%, mass >7cm in 50% and 73% were CD5+. The activated B Cell subtype was identified in 1/3 of the cases. Five were double/triple-expressor and two double-hit.
Twenty-four patients underwent in second-line therapies. Only 29% (n=7) achieved CR (R-ICE n=3; R-DHAP n=2; R-Bendamustine n=1; CVP n=1). Four patients underwent autotransplantation. Eight performed ≥3 therapeutic lines.
The median follow-up was 19.3 months. The mortality rate was 36%. 71% died from disease progression. The median overall survival of patients undergoing 1st CIT was 39 months.
Conclusion
By advanced age, commorbidities and/or high ECOG, only 54% of patients with DLBCL or HG- DLBCL were elected to curative CIT. Of the remaining, only 9 are alive with follow-up time ≥ 18 months. The patients studied presented characteristics, risk factors and unsatisfactory responses to CIT in R/R, as described in the literature. Thus, we emphasize the need for therapeutic strategies adapted to improve prognosis.
Keyword(s): Diffuse large B cell lymphoma, Relapsed lymphoma, Treatment