Diffuse large B-cell lymphoma with primary treatment failure: Ultra-high risk features and benchmarking for experimental therapies
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- 作者：Luciano J. Costa ; Kami Maddocks ; Narendranath Epperla ; Nishitha M. Reddy ; Reem Karmali ; Elvira Umyarova ; Veronika Bachanova ; Cristiana Costa ; Martha J. Glenn ; Julio C. Chavez ; Oscar Calzada ; Frederick Lansigan ; Hossain Nasheed ; Stefan K. Barta ; Zheng Zhou ; Michael Jaglal ; Saurabh Chhabra ; Francisco Hernandez-Ilizaliturri ; Ana C. Xavier ; Amitkumar Mehta ; Deniz Peker ; Andreas Forero-Torres ; Zeina Al-Mansour ; Andrew M. Evens ; Jonathon B. Cohen ; Christopher R. Flowers ; Timothy S. Fenske and Mehdi Hamadani
- 刊名：American Journal of Hematology
- 出版年：2017
- 出版时间：February 2017
- 年：2017
- 卷：92
- 期：2
- 页码：161-170
- 全文大小：760K
- ISSN：1096-8652
文摘
The outcomes of patients with DLBCL and primary treatment failure (PTF) in the rituximab era are unclear. We analyzed 331 patients with PTF, defined as primary progression while on upfront chemoimmunotherapy (PP), residual disease at the end of upfront therapy (RD) or relapse < 6 months from end of therapy (early relapse; ER). Median age was 58 years and response to salvage was 41.7%. Two-year OS was 18.5% in PP, 30.6% in RD and 45.5% in ER. The presence of PP, intermediate-high/high NCCN-IPI at time of PTF or MYC translocation predicted 2-year OS of 13.6% constituting ultra-high risk (UHR) features. Among the 132 patients who underwent autologous hematopoietic cell transplantation, 2-year OS was 74.3%, 59.6% and 10.7% for patients with 0,1 and 2–3 UHR features respectively. Patients with PTF and UHR features should be prioritized for clinical trials with newer agents and innovative cellular therapy.