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Clinical and treatment‐related features determining the risk of late relapse in patients with diffuse large B‐cell lymphoma
Author(s) -
Modvig Lena,
Vase Maja,
d‘Amore Francesco
Publication year - 2017
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/bjh.14822
Subject(s) - rituximab , medicine , diffuse large b cell lymphoma , lymphoma , oncology , international prognostic index , population , radiation therapy , environmental health
Summary It is still unclear whether there are clinically exploitable differences in the biology and behaviour of early versus late relapses in diffuse large B‐cell lymphoma ( DLBCL ). The present study aimed to analyse a large population‐based DLBCL cohort in order to identify (i) the frequency of late relapses ( LR ), (ii) parameters influencing the risk of LR , and (iii) the impact of introducing rituximab on the occurrence of LR . The data of 7247 DLBCL patients was obtained from the Danish Lymphoma Group Registry. Patients with LR had a lower International Prognostic Index and better performance score than early relapse ( ER ) patients. The use of radiotherapy lowered only the rate of ER while the use of rituximab yielded a lower occurrence of both ER and LR ( P < 0·0001 and P < 0·0001, respectively), possibly suggesting a longer‐lasting biological effect. Additionally, we found a female overrepresentation among LR patients that had received a rituximab‐containing first line treatment. It was found that patients with LR had a significantly better 5‐year overall survival compared to ER patients. In conclusion, LR was more frequently associated with low‐risk features than ER . Furthermore, we found that the use of modern immunochemotherapy regimens in DLBCL lowers the risk of both ER and LR .