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. 2023 Jan;55(1):325-333.
doi: 10.4143/crt.2022.008. Epub 2022 Apr 22.

Outcomes in Refractory Diffuse Large B-Cell Lymphoma: Results from Two Prospective Korean Cohorts

Jun Ho Yi  1 , Seong Hyun Jeong  2 , Seok Jin Kim  3 , Dok Hyun Yoon  4 , Hye Jin Kang  5 , Youngil Koh  6 , Jin Seok Kim  7 , Won-Sik Lee  8 , Deok-Hwan Yang  9 , Young Rok Do  10 , Min Kyoung Kim  11 , Kwai Han Yoo  12 , Yoon Seok Choi  2 , Whan Jung Yun  13 , Yong Park  14 , Jae-Cheol Jo  15 , Hyeon-Seok Eom  16 , Jae-Yong Kwak  17 , Ho-Jin Shin  18 , Byeong Bae Park  19 , Seong Yoon Yi  20 , Ji-Hyun Kwon  21 , Sung Yong Oh  22 , Hyo Jung Kim  23 , Byeong Seok Sohn  24 , Jong Ho Won  25 , Dae-Sik Hong  26 , Ho-Sup Lee  27 , Gyeong-Won Lee  28 , Cheolwon Suh  4 , Won Seog Kim  3
Affiliations

Outcomes in Refractory Diffuse Large B-Cell Lymphoma: Results from Two Prospective Korean Cohorts

Jun Ho Yi et al. Cancer Res Treat. 2023 Jan.

Abstract

Purpose: Diffuse large B-cell lymphoma (DLBCL) is the most common hematologic malignancy worldwide. Although substantial improvement has been achieved by the frontline rituximab-based chemoimmunotherapy, up to 40%-50% of patients will eventually have relapsed or refractory disease, whose prognosis is extremely dismal.

Materials and methods: We have carried out two prospective cohort studies that include over 1,500 DLBCL patients treated with rituximab plus CHOP (#NCT01202448 and #NCT02474550). In the current report, we describe the outcomes of refractory DLBCL patients. Patients were defined to have refractory DLBCL if they met one of the followings, not achieving at least partial response after 4 or more cycles of R-CHOP; not achieving at least partial response after 2 or more cycles of salvage therapy; progressive disease within 12 months after autologous stem cell transplantation.

Results: Among 1,581 patients, a total of 260 patients met the criteria for the refractory disease after a median time to progression of 9.1 months. The objective response rate of salvage treatment was 26.4%, and the complete response rate was 9.6%. The median overall survival (OS) was 7.5 months (95% confidence interval, 6.4 to 8.6), and the 2-year survival rate was 22.1%±2.8%. The median OS for each refractory category was not significantly different (p=0.529).

Conclusion: In line with the previous studies, the outcomes of refractory DLBCL patients were extremely poor, which necessitates novel approaches for this population.

Keywords: Clinical outcomes; Diffuse large B-cell lymphoma; Refractory.

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Conflict of interest statement

Conflicts of Interest

Conflict of interest relevant to this article was not reported.

Figures

Fig. 1
Fig. 1
Patient inclusion and flow diagram. ASCT, autologous stem cell transplantation; CR, complete response; NE, not evaluable; PD, progressive disease; PR, partial response; SD, stable disease.
Fig. 2
Fig. 2
Overall survival from commencement of salvage therapy: overall population (A); by refractory category (B); by tumor response (C); by cell-of-origin subtype (D). ASCT, autologous stem cell transplantation; CR, complete response; GCB, germinal center B-cell; PD, progressive disease; PR, partial response; SD, stable disease.
See this image and copyright information in PMC

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