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KMID : 0939920230550010325
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대한암학회지
2023 Volume.55 No. 1 p.325 ~ p.333
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Outcomes in Refractory Diffuse Large B-Cell Lymphoma: Results from Two Prospective Korean Cohorts
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Lee Jun-Ho
Jeong Seong-Hyun
Kim Suk-Jin
Kang Hye-Jin
Kim Jin-Seok
Yang Deok-Hwan
Do Young-Rok
Kim Min-Kyung
Choi Yoon-Seok
Park Yong
Jo Jae-Cheol
Eom Hyeon-Seok
Kwak Jae-Yong
Shin Ho-Jin
Park Byeong-Bae
Kwon Ji-Hyun
Oh Sung-Yong
Kim Hyo-Jung
Sohn Byeong-Seok
Won Jong-Ho
Hong Dae-Sik
Lee Ho-Sup
Lee Gyeong-Won
Suh Cheol-Won
Kim Won-Seog
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Abstract
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Purpose : Diffuse large B-cell lymphoma (DLBCL) is the most common hematologic malignancy worldwide. Although substantial improvement has been achieved by the frontline rituximab-based chemoimmunotherapy, up to 40%?50% of patients will eventually have relapsed or refractory disease, whose prognosis is extremely dismal.
Materials and Methods : We have carried out two prospective cohort studies that include over 1,500 DLBCL patients treated with rituximab plus CHOP (#NCT01202448 and #NCT02474550). In the current report, we describe the outcomes of refractory DLBCL patients. Patients were defined to have refractory DLBCL if they met one of the followings, not achieving at least partial response after 4 or more cycles of R-CHOP; not achieving at least partial response after 2 or more cycles of salvage therapy; progressive disease within 12 months after autologous stem cell transplantation.
Results : Among 1,581 patients, a total of 260 patients met the criteria for the refractory disease after a median time to progression of 9.1 months. The objective response rate of salvage treatment was 26.4%, and the complete response rate was 9.6%. The median overall survival (OS) was 7.5 months (95% confidence interval, 6.4 to 8.6), and the 2-year survival rate was 22.1%±2.8%. The median OS for each refractory category was not significantly different (p=0.529).
Conclusion : In line with the previous studies, the outcomes of refractory DLBCL patients were extremely poor, which necessitates novel approaches for this population.
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KEYWORD
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Diffuse large B-cell lymphoma, Refractory, Clinical outcomes
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