Ting, Choo-Yuen and Gan, Gin-Gin and Ong, Diana Bee-Lan and Tan, Soo-Yong and Bee, Ping-Chong (2020) Extranodal site of diffuse large B-cell lymphoma and the risk of R-CHOP chemotherapy resistance and early relapse. International Journal of Clinical Practice, 74 (10). ISSN 13685031, DOI https://doi.org/10.1111/ijcp.13594.
Full text not available from this repository.Abstract
Background About 20%-30% of diffuse large B-cell lymphoma (DLBCL) patients experience early disease progression despite R-CHOP chemotherapy treatment. Revised international prognostic index (R-IPI) score could risk stratify DLBCL patients but does not identify exactly which patient will be resistant to R-CHOP therapy or experience early relapse. Aims of the Study To analyse pre-treatment clinical features of DLBCL patients that are predictive of R-CHOP therapy resistance and early disease relapse after R-CHOP therapy treatment. Methods Used to Conduct the Study A total of 698 lymphoma patients were screened and 134 R-CHOP-treated DLBCL patients were included. The Lugano 2014 criteria was applied for assessment of treatment response. DLBCL patients were divided into R-CHOP resistance/early relapse group and R-CHOP sensitive/late relapse group. Results of the Study 81 of 134 (60%) were R-CHOP sensitive/late relapse, while 53 (40%) were R-CHOP resistance/early relapse. The median follow-up period was 59 months +/- standard error 3.6. Five-year overall survival rate of R-CHOP resistance/early relapse group was 2.1%, while it was 89% for RCHOP sensitive/late relapse group. Having more than one extranodal site of DLBCL disease is an independent risk factor for R-CHOP resistance/early relapse odds ratio = 5.268 (1.888-14.702),P = .002]. The commonest extranodal sites were head and neck, gastrointestinal tract, respiratory system, vertebra and bones. Advanced age (>60 years), advanced disease stage (lll-lV), raised pre-treatment lactate dehydrogenase level, bone marrow involvement of DLBCL disease high Eastern Cooperative Oncology Group status (2-4) and high R-IPI score (3-5) showed no significant association with R-CHOP therapy resistance/early disease relapse (multivariate analysis:P > .05). Conclusion and Clinical Implications DLBCL patients with more than one extranodal site are 5.268 times more likely to be R-CHOP therapy resistance or experience early disease relapse after R-CHOP therapy. Therefore, correlative studies are warranted in DLBCL patients with more than one extranodal site of disease to explore possible underlying mechanisms of chemoresistance.
| Item Type: | Article |
|---|---|
| Funders: | Malaysian Society of Haematology, Metro South Health |
| Uncontrolled Keywords: | Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Cyclophosphamide; Doxorubicin; Drug Resistance, Neoplasm; Female; Humans; Lymphoma, Large B-Cell, Diffuse; Male; Middle Aged; Neoplasm Recurrence, Local; Prednisone; Prognosis; Risk Factors; Rituximab; Survival Rate; Treatment Outcome; Vincristine |
| Subjects: | R Medicine > R Medicine (General) R Medicine > RB Pathology |
| Divisions: | Faculty of Medicine > Medicine Department Faculty of Medicine > Pathology Department |
| Depositing User: | Ms Zaharah Ramly |
| Date Deposited: | 29 Oct 2024 08:08 |
| Last Modified: | 29 Oct 2024 08:08 |
| URI: | http://eprints.um.edu.my/id/eprint/36550 |
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