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Prognosis of patients with diffuse large B cell lymphoma not reaching complete response or relapsing after frontline chemotherapy or immunochemotherapy

A retrospective study was performed to assess the outcome of patients with diffuse large B cell lymphoma (DLBCL) who did not achieve complete response or who relapsed before and after the use of rituximab. Clinical features and outcome of 816 (425 M/391 F; median age 63 years) patients diagnosed fro...

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Detalles Bibliográficos
Autores principales: Rovira, Jordina, Valera, Alexandra, Colomo, Lluis, Setoain, Xavier, Rodríguez, Sonia, Martínez-Trillos, Alejandra, Giné, Eva, Dlouhy, Ivan, Magnano, Laura, Gaya, Anna, Martínez, Daniel, Martínez, Antonio, Campo, Elías, López-Guillermo, Armando
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4374121/
https://www.ncbi.nlm.nih.gov/pubmed/25501975
http://dx.doi.org/10.1007/s00277-014-2271-1
Descripción
Sumario:A retrospective study was performed to assess the outcome of patients with diffuse large B cell lymphoma (DLBCL) who did not achieve complete response or who relapsed before and after the use of rituximab. Clinical features and outcome of 816 (425 M/391 F; median age 63 years) patients diagnosed from 1991 to 2001 (pre-rituximab era, N = 348) and from 2002 to 2012 (rituximab era, N = 468) in a single institution were evaluated. Five hundred fifty-three patients achieved complete remission (CR), 57 partial response (PR), and 206 were refractory with a median overall survival of 15, 1.5, and 0.4 years, respectively. Patients receiving rituximab had lower risk of refractoriness or relapse. In primarily refractory and PR patients, there was not a difference in survival depending on whether patients received or not rituximab-containing frontline treatment. Early death rate was 11 %, including 3.6 % due to infectious complications. Rituximab did not modify these figures. In the relapse setting, 5-year survival from relapse was 25 % for patients who never received rituximab, 54 % for those who received rituximab only at relapse, and 48 % for those treated with immunochemotherapy both as frontline and at relapse. In conclusion, relapsed/refractory patients with DLBCL show poor prognosis despite the use of frontline immunochemotherapy. New therapeutic approaches are needed in this group of patients.