Back to Search
Start Over
Characteristics and Management of TP53-Mutated Diffuse Large B-Cell Lymphoma Patients
- Source :
- Cancer Management and Research. 12:11515-11522
- Publication Year :
- 2020
- Publisher :
- Informa UK Limited, 2020.
-
Abstract
- Background/aim TP53 mutation is recognized as a negative prognostic factor for patients with diffuse large B-cell lymphoma (DLBCL). Here, we present the characteristics of TP53 mut DLBCL patients following investigation of the effect of a treatment approach on survival of TP53 mut DLBCL patients. Methods A total of 44 DLBCL patients with TP53 mut and treated with an R-CHOP regimen were included for analysis. Patients who failed to achieve a complete response (CR) to initial treatment or relapsed in the first 6 months after initial CR were deemed to have primary refractory disease. Results Among 44 patients harboring TP53 mutations who underwent upfront R-CHOP or R-CHOP-like treatment, 21 (47.7%) had limited-stage and 23 (52.3%) presented advanced-stage disease. Apart from the seven patients receiving upfront surgical resection, 37 had measurable disease under the R-CHOP regimen, with 59.1% (n=26) developing primary refractory disease. Seven limited-stage patients after early complete resection and one with residue resection remained event-free at median follow-up of 37 months. Multivariate analysis revealed that elevated baseline lactate dehydrogenase (LDH), extranodal involvement (two or more), Ann Arbor stage, and locoregional treatment (surgery or radiation therapy) were independent indicators for progression-free survival (PFS). After adjustment for baseline LDH and extranodal involvement, adding locoregional treatment including surgery and radiation to the R-CHOP regimen significantly improved PFS (p=0.008) and overall survival (p=0.017) in limited-stage TP53 mut DLBCL patients compared to R-CHOP-only treatment. Conclusion This study presents the characteristics of TP53-mutated DLBCL and implies a potential benefit of locoregional treatment in limited-stage DLBCL patients with TP53 mutations.
- Subjects :
- 0301 basic medicine
medicine.medical_specialty
medicine.medical_treatment
Disease
Gastroenterology
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
immune system diseases
hemic and lymphatic diseases
Internal medicine
Lactate dehydrogenase
medicine
Stage (cooking)
Extranodal Involvement
neoplasms
business.industry
medicine.disease
Lymphoma
Radiation therapy
Regimen
030104 developmental biology
Oncology
chemistry
030220 oncology & carcinogenesis
business
Diffuse large B-cell lymphoma
Subjects
Details
- ISSN :
- 11791322
- Volume :
- 12
- Database :
- OpenAIRE
- Journal :
- Cancer Management and Research
- Accession number :
- edsair.doi...........6024fff0bf79828d504c4ca9aa874862