Outcome of Diffuse Large B-Cell Lymphoma with First-line Chemotherapy
Background: Diffuse Large B-Cell Lymphoma (DLBCL), most common Non-Hodgkin Lymphoma (NHL) variety, is an aggressive, fast-growing form comprising up to 40% of all cases globally. Objective: To observe the treatment outcome of different subtypes of Diffuse Large B-Cell Lymphoma (DLBCL) after first-line chemotherapy and also the association with IHC, presenting age, sex, and IPI score with outcome. Methodology: This is a retrospective data analysis included all DLBCL patients registered in the department of Haematology of National Institute of Cancer Research and Hospital (NICRH) between July 2016 to June 2019. Results: Total 188 cases were included in this study and mean age was 48 years with a Standard deviation of 15 years with Male (69.1%) predominance. We divide the cases into three different entities of DLBCL [Germinal Centre B-cell like (GCB), Non-GCB and others (NOS) among them Non-GCB variety was the prevalent (47.3%) one. After first line chemotherapy 52.1% complete remission with 7% death was observed in overall outcome. There was no significant difference in outcome among different types of DLBCL after chemotherapy based on Han’s algorithm. Rituximab with CHOP has significantly better outcome than CHOP alone arm (p: 0.021). Conclusion: This limited database study of NICRH will help to ascertain the outcome of DLBCL after first-line chemotherapy in Bangladesh.
Gascoyne R D, Campo E, Jaffe E S, Chan W C, Chan J K C, Rosenwald A, Stein H, Swerdlow S H. Diffuse large b-cell Lymphoma, NOS. In: Swerdlow S H, Campo E, Harris N L, Jaffe E S, Pileri S A, Stein H, Thieli J. editors. WHO classification of tumours of Haematopoietic and Lymphoid Tissue. Revised 4th Ed. Lyon: IARC, 2017; p-291.
Swerdlow SH, Campo E, Pileri SA, Harris NL, Stein H, Siebert R, Advani R, Ghielmini M, Salles GA, Zelenetz AD, Jaffe ES. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood. 2016 May 19;127(20):2375-2390.
Fisher RI, Gaynor ER, Dahlberg S, Oken MM, Grogan TM, Mize EM, Glick JH, Coltman Jr CA, Miller TP. Comparison of a standard regimen (CHOP) with three intensive chemotherapy regimens for advanced non-Hodgkin's lymphoma. New England Journal of Medicine. 1993 Apr 8;328(14):1002-1006.
Feugier P, Van Hoof A, Sebban C, Solal-Celigny P, Bouabdallah R, Ferme C, Christian B, Lepage E, Tilly H, Morschhauser F, Gaulard P. Long-term results of the R-CHOP study in the treatment of elderly patients with diffuse large B-cell lymphoma: a study by the Groupe d’Etude des Lymphomes de l’Adulte. J Clin Oncol. 2005 Jun 20;23(18):4117-4126.
Hans CP, Weisenburger DD, Greiner TC, Gascoyne RD, Delabie J, Ott G, et al. Confirmation of the molecular classification of diffuse large B-cell lymphoma by immunohistochemistry using a tissue microarray. Blood. 2004; 103:275–282.
Cheson BD, Pfistner B, Juweid ME, Gascoyne RD, Specht L, Horning SJ, et al. Revised response criteria for malignant lymphoma. J Clin Oncol. 2007; 25:579–586.
Gogia A, Das CK, Kumar L, Sharma A, Tiwari A, Sharma MC, Mallick S. Diffuse large B-cell lymphoma: An institutional analysis. South Asian journal of cancer. 2018 Jul;7(3):200.
Nimmagadda RB, Digumarti R, Nair R, Bhurani D, Raina V, and Aggarwal S, et al. Histopathological pattern of lymphomas and clinical presentation and outcomes of diffuse large B cell lymphoma: A multicenter registry based study from India. Indian J Med Paediatr Oncol. 2013; 34:299–304.
Prakash G, Sharma A, Raina V, Kumar L, Sharma MC, Mohanti BK, et al. Bcell non-Hodgkin's lymphoma: Experience from a tertiary care cancer centre. Ann Hematol. 2012; 91:1603–1611.
Gouill SL, Talmant P, Touzeau C, Moreau A, Garand R, Juge-Morineau N, et al. The clinical presentation and prognosis of diffuse large B-cell lymphoma with t (14; 18) and 8q24/c-MYC rearrangement. haematologica/the hematology journal. 2007; 92(10):1335-1342.
Matej Horvat,Vesna zadnik,Barbara jezersek Novakovic:DLBCL:10 year real world clinical experienced withrituximab plus Cyclophosphamide, doxorubicin, vincristine, prednisolone:oncol let,2018,Mar;15(3):3602-3609.
Coiffier B, Lepage E, Briere J, Herbrecht R, Tilly H, Bouabdallah R, et al. Chop chemotherapy plus rituximab compared with chop alone in elderly patients with diffuse large-b-cell lymphoma. N Engl J Med. 2002; 346 (4): 235-242.
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Copyright (c) 2020 Zulfia Zinat Chowdhury, Tamanna Bahar, Shaila Rahman, Salina Haque, A K M Mynul Islam, Mohammad Ali, Md. Mahbubur Rahman
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