2020
The interval between progression and therapy initiation is the key prognostic parameter in relapsing diffuse large B cell lymphoma: analysis from the Czech Lymphoma Study Group database (NIHIL)
JANÍKOVÁ, Andrea; Jozef MICHALKA; Zbyněk BORTLÍČEK; Renata CHLOUPKOVÁ; Vit CAMPR et al.Základní údaje
Originální název
The interval between progression and therapy initiation is the key prognostic parameter in relapsing diffuse large B cell lymphoma: analysis from the Czech Lymphoma Study Group database (NIHIL)
Autoři
JANÍKOVÁ, Andrea; Jozef MICHALKA; Zbyněk BORTLÍČEK; Renata CHLOUPKOVÁ; Vit CAMPR; Natasa KOPALOVA; Pavel KLENER; Katerina BENESOVA; Jitka HAMOUZOVA; David BELADA; Vit PROCHAZKA; Robert PYTLIK; Jan PIRNOS; Juraj DURAS; Heidi MOCIKOVA a Marek TRNENY
Vydání
Annals of hematology, New York, Springer Verlag, 2020, 0939-5555
Další údaje
Jazyk
angličtina
Typ výsledku
Článek v odborném periodiku
Obor
30205 Hematology
Stát vydavatele
Velká Británie a Severní Irsko
Utajení
není předmětem státního či obchodního tajemství
Odkazy
Impakt faktor
Impact factor: 3.673
Označené pro přenos do RIV
Ano
Kód RIV
RIV/00216224:14110/20:00116004
Organizační jednotka
Lékařská fakulta
UT WoS
EID Scopus
Klíčová slova anglicky
Diffuse large B cell lymphoma; Prognosis; Relapse; Therapy
Příznaky
Mezinárodní význam, Recenzováno
Změněno: 31. 8. 2020 12:17, Mgr. Tereza Miškechová
Anotace
V originále
Relapsing diffuse large B cell lymphomas (rDLBCL) represent a heterogeneous disease. This heterogeneity should be recognized and reflected, because it can deform the interpretation of clinical trial results. DLBCL patients with the first relapse and without CNS involvement were identified in the Czech Lymphoma Study Group (CLSG) database. Interval-to-therapy (ITT) was defined as the time between the first manifestation of rDLBCL and the start of any treatment. The overall survival (OS) of different ITT cohorts (< 7 vs. 7-21 vs. > 21 days) was compared. In total, 587 rDLBCLs (51.8% males) progressed with a median of 12.8 months (range 1.6 to 152.3) since the initial diagnosis (2000-2017). At the time of relapse, the median age was 67 years (range 22-95). First-line therapy was administered in 99.3% of the patients; CHOP and anti-CD20 were given to 69.2% and 84.7% of the patients, respectively. The salvage immune/chemotherapy was administered in 88.1% of the patients (39.2% platinum-based regimen). The median ITT was 20 days (range 1-851), but 23.2% of patients initiated therapy within 7 days. The 5-year OS was 17.4% (range 10-24.5%) vs. 20.5% (range 13.5-27.4%) vs. 42.2% (range 35.5-48.8%) for ITT < 7 vs. 7-21 vs. > 21 days (p < 0.001). ITT was associated with B symptoms (p 0.004), ECOG (p < 0.001), stage (p 0.002), bulky disease (p 0.005), elevated LDH (p < 0.001), and IPI (p < 0.001). The ITT mirrors the real clinical behavior of rDLBCL. There are patients (ITT < 7 days) with aggressive disease and a poor outcome. Conversely, there are rDLBCLs with ITT >= 21 days who survive for a long time.