Late relapse in patients with diffuse large B-cell lymphoma

Br J Haematol. 2010 Nov;151(4):354-8. doi: 10.1111/j.1365-2141.2010.08330.x. Epub 2010 Sep 29.

Abstract

The outcomes for 162 patients with diffuse large B-cell lymphoma treated with a CHOP (cyclophosphamide, doxorubicin, vincristine, prednisolone)-like regimen who obtained a complete remission and who subsequently relapsed after ≥5 years of remission (late relapse, N=30), or <5 years of remission (early relapse, N=132), were compared. The late relapsing patients had better prognostic characteristics at diagnosis, such as stage I/II disease (73% vs. 49%, P=0·04), a normal lactic dehydrogenase (77% vs. 48%, P=0·01), and a Karnofsky performance score of ≥80 (100% vs. 86%, P=0·01). The 3-year survival after relapse was better in late relapsing patients (48% vs. 25%, P=0·03), but the survival at 5 years (32% vs. 20%) and 10 years (13% vs. 14%) after relapse was not different. A multivariate analysis of factors predicting survival after relapse found age (P<0·0001) and presence of B-symptoms (P=0·03) to predict survival, but not early versus late relapse. A small percentage of the late relapsing patients can have a prolonged second remission. However, the overall survival from the time of relapse was not different between early and late relapsing patients with most succumbing to lymphoma.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Biomarkers, Tumor / blood
  • Cyclophosphamide / therapeutic use
  • Doxorubicin / therapeutic use
  • Epidemiologic Methods
  • Female
  • Humans
  • L-Lactate Dehydrogenase / blood
  • Lymphoma, Large B-Cell, Diffuse / diagnosis
  • Lymphoma, Large B-Cell, Diffuse / drug therapy*
  • Lymphoma, Large B-Cell, Diffuse / pathology
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Prednisolone / therapeutic use
  • Prognosis
  • Recurrence
  • Remission Induction
  • Time Factors
  • Vincristine / therapeutic use
  • Young Adult

Substances

  • Biomarkers, Tumor
  • Vincristine
  • Doxorubicin
  • Cyclophosphamide
  • Prednisolone
  • L-Lactate Dehydrogenase

Supplementary concepts

  • VAP-cyclo protocol