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@article{1670466,
author = {Janíková, Andrea and Michalka, Jozef and Bortlíček, Zbyněk and Chloupková, Renata and Campr, Vit and Kopalova, Natasa and Klener, Pavel and Benesova, Katerina and Hamouzova, Jitka and Belada, David and Prochazka, Vit and Pytlik, Robert and Pirnos, Jan and Duras, Juraj and Mocikova, Heidi and Trneny, Marek},
article_location = {New York},
article_number = {7},
doi = {http://dx.doi.org/10.1007/s00277-020-04099-y},
keywords = {Diffuse large B cell lymphoma; Prognosis; Relapse; Therapy},
language = {eng},
issn = {0939-5555},
journal = {Annals of hematology},
title = {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)},
url = {https://link.springer.com/article/10.1007%2Fs00277-020-04099-y},
volume = {99},
year = {2020}
}
TY - JOUR
ID - 1670466
AU - Janíková, Andrea - Michalka, Jozef - Bortlíček, Zbyněk - Chloupková, Renata - Campr, Vit - Kopalova, Natasa - Klener, Pavel - Benesova, Katerina - Hamouzova, Jitka - Belada, David - Prochazka, Vit - Pytlik, Robert - Pirnos, Jan - Duras, Juraj - Mocikova, Heidi - Trneny, Marek
PY - 2020
TI - 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)
JF - Annals of hematology
VL - 99
IS - 7
SP - 1583-1594
EP - 1583-1594
PB - Springer Verlag
SN - 09395555
KW - Diffuse large B cell lymphoma
KW - Prognosis
KW - Relapse
KW - Therapy
UR - https://link.springer.com/article/10.1007%2Fs00277-020-04099-y
L2 - https://link.springer.com/article/10.1007%2Fs00277-020-04099-y
N2 - 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.
ER -
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 and Marek TRNENY. 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). \textit{Annals of hematology}. New York: Springer Verlag, 2020, vol.~99, No~7, p.~1583-1594. ISSN~0939-5555. Available from: https://dx.doi.org/10.1007/s00277-020-04099-y.
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