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Costa LJ , Maddocks K , Epperla N , Reddy NM , Karmali R , Umyarova E , Bachanova V , Costa C , Glenn MJ , Chavez JC , Calzada O , Lansigan F , Nasheed H , Barta SK , Zhou Z , Jaglal M , Chhabra S , Hernandez-Ilizaliturri F , Xavier AC , Mehta A , Peker D , Forero-Torres A , Al-Mansour Z , Evens AM , Cohen JB , Flowers CR , Fenske TS , Hamadani M
Diffuse large B-cell lymphoma with primary treatment failure: Ultra-high risk features and benchmarking for experimental therapies
Am J Hematol. 2017 Feb;92(2) :161-170
PMID: 27880984    PMCID: PMC5549936    URL: https://www.ncbi.nlm.nih.gov/pubmed/27880984
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Abstract
The outcomes of patients with DLBCL and primary treatment failure (PTF) in the rituximab era are unclear. We analyzed 331 patients with PTF, defined as primary progression while on upfront chemoimmunotherapy (PP), residual disease at the end of upfront therapy (RD) or relapse < 6 months from end of therapy (early relapse; ER). Median age was 58 years and response to salvage was 41.7%. Two-year OS was 18.5% in PP, 30.6% in RD and 45.5% in ER. The presence of PP, intermediate-high/high NCCN-IPI at time of PTF or MYC translocation predicted 2-year OS of 13.6% constituting ultra-high risk (UHR) features. Among the 132 patients who underwent autologous hematopoietic cell transplantation, 2-year OS was 74.3%, 59.6% and 10.7% for patients with 0,1 and 2-3 UHR features respectively. Patients with PTF and UHR features should be prioritized for clinical trials with newer agents and innovative cellular therapy.
Notes
Costa, Luciano J Maddocks, Kami Epperla, Narendranath Reddy, Nishitha M Karmali, Reem Umyarova, Elvira Bachanova, Veronika Costa, Cristiana Glenn, Martha J Chavez, Julio C Calzada, Oscar Lansigan, Frederick Nasheed, Hossain Barta, Stefan K Zhou, Zheng Jaglal, Michael Chhabra, Saurabh Hernandez-Ilizaliturri, Francisco Xavier, Ana C Mehta, Amitkumar Peker, Deniz Forero-Torres, Andreas Al-Mansour, Zeina Evens, Andrew M Cohen, Jonathon B Flowers, Christopher R Fenske, Timothy S Hamadani, Mehdi eng 2016/11/24 06:00 Am J Hematol. 2017 Feb;92(2):161-170. doi: 10.1002/ajh.24615.