J 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

EID Scopus

Klíčová slova anglicky

Diffuse large B cell lymphoma; Prognosis; Relapse; Therapy

Štítky

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.