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Real life clinical outcomes of relapsed/refractory diffuse large B cell lymphoma in the rituximab era: The STRIDER study.
- Source :
-
Cancer medicine [Cancer Med] 2024 Jul; Vol. 13 (14), pp. e7448. - Publication Year :
- 2024
-
Abstract
- Background: Relapse and refractory (R/R) rates after first-line R-CHOP in diffuse large B cell lymphomas (DLBCL) are ~40% and ~15% respectively.<br />Aims: We conducted a retrospective real-world analysis aimed at evaluating clinical outcomes of R/R DLBCL patients.<br />Material and Methods: Overall, 403 consecutive DLBCL patients treated in two large hematological centers in Torino, Italy were reviewed.<br />Results: At a median follow up of 50 months, 5-year overall survival from diagnosis (OS-1) was 66.5%, and 2-year progression free survival (PFS-1) was 68%. 134 (34.4%) patients relapsed (n = 46, 11.8%) or were refractory (n = 88, 22.6%) to R-CHOP. Most employed salvage treatments included platinum salt-based regimens in 38/134 (28.4%), lenalidomide in 14 (10.4%). Median OS and PFS after disease relapse or progression (OS-2 and PFS-2) were 6.7 and 5.1 months respectively. No significant difference in overall response rate, OS-2 or PFS-2 in patients treated with platinum-based regimens versus other regimens was observed. By multivariate analysis, age between 60 and 80 years, germinal center B cell type cell of origin and extranodal involvement of <2 sites were associated with better OS-2.<br />Discussion: Our findings confirm very poor outcomes of R/R DLBCL in the rituximab era. Widespread approval by national Medicine Agencies of novel treatments such as CAR-T cells and bispecific antibodies as second-line is eagerly awaited to improve these outcomes.<br /> (© 2024 The Author(s). Cancer Medicine published by John Wiley & Sons Ltd.)
- Subjects :
- Humans
Male
Female
Middle Aged
Aged
Retrospective Studies
Adult
Aged, 80 and over
Neoplasm Recurrence, Local drug therapy
Treatment Outcome
Drug Resistance, Neoplasm
Young Adult
Prednisone therapeutic use
Prednisone administration & dosage
Salvage Therapy
Italy
Cyclophosphamide therapeutic use
Vincristine therapeutic use
Progression-Free Survival
Doxorubicin therapeutic use
Doxorubicin administration & dosage
Lymphoma, Large B-Cell, Diffuse drug therapy
Lymphoma, Large B-Cell, Diffuse mortality
Lymphoma, Large B-Cell, Diffuse pathology
Rituximab therapeutic use
Rituximab administration & dosage
Antineoplastic Combined Chemotherapy Protocols therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 2045-7634
- Volume :
- 13
- Issue :
- 14
- Database :
- MEDLINE
- Journal :
- Cancer medicine
- Publication Type :
- Academic Journal
- Accession number :
- 39030982
- Full Text :
- https://doi.org/10.1002/cam4.7448