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The Prognostic Impact of Comorbidities in Patients with De-Novo Diffuse Large B-Cell Lymphoma Treated with R-CHOP Immunochemotherapy in Curative Intent
- Source :
- Journal of Clinical Medicine, Volume 9, Issue 4, Journal of Clinical Medicine, Vol 9, Iss 1005, p 1005 (2020)
- Publication Year :
- 2020
- Publisher :
- Multidisciplinary Digital Publishing Institute, 2020.
-
Abstract
- Background: Patient-related factors, namely comorbidities, impact the clinical outcome of patients with diffuse large B-cell lymphoma (DLBCL). Methods: The prevalence and prognostic impact of comorbidities were examined using the validated scores Charlson Comorbidity Index (CCI) and Hematopoietic Cell Transplantation-specific Comorbidity Index (HCT-CI) in 181 patients with DLBCL at initial diagnosis before treatment with rituximab, cyclophosphamide, vincristine, doxorubicin and prednisone (R-CHOP). Results: Pronounced comorbidities as defined by CCI and HCT-CI scoring of &ge<br />2 were detected in 9.9% and 28.2% of patients, respectively, and occurred more frequently at advanced age (p &lt<br />0.001). Higher CCI scoring was associated with lower complete response rate (p = 0.020). Both advanced CCI and HCT-CI were significantly associated with shortened overall survival (3-year OS: CCI &ge<br />2 vs. 0&ndash<br />1, 38.9% vs. 81.3%, p &lt<br />0.001<br />HCT-CI &ge<br />1, 56.9% vs. 84.9%, p &lt<br />0.001). Both comorbidity scores remained independent risk factors in the multivariate analysis (HCT-CI &ge<br />2 HR: 2.6, p = 0.004<br />CCI &ge<br />2 HR: 3.6, p = 0.001). Conclusion: This study demonstrates the prognostic relevance of comorbidities classified by CCI and HCT-CI in patients with DLBCL undergoing curative treatment with R-CHOP. A structured evaluation of comorbidities might refine prognostication alongside currently used prognostic parameters, namely age, and should be evaluated in prospective trials.
- Subjects :
- Oncology
Vincristine
medicine.medical_specialty
Multivariate analysis
Cyclophosphamide
lcsh:Medicine
HCT-CI
comorbidities
Article
03 medical and health sciences
0302 clinical medicine
Prednisone
immune system diseases
Internal medicine
hemic and lymphatic diseases
mental disorders
medicine
030304 developmental biology
0303 health sciences
business.industry
CCI
lcsh:R
General Medicine
medicine.disease
Comorbidity
Lymphoma
R-CHOP
030220 oncology & carcinogenesis
DLBCL
Rituximab
prognosis
business
Diffuse large B-cell lymphoma
medicine.drug
Subjects
Details
- Language :
- English
- ISSN :
- 20770383
- Database :
- OpenAIRE
- Journal :
- Journal of Clinical Medicine
- Accession number :
- edsair.doi.dedup.....09f61e4ae109c49f82861b0a1b0c9e0f
- Full Text :
- https://doi.org/10.3390/jcm9041005