Novel model predicts prognosis for patients with diffuse large B-cell lymphoma in first relapse after initial R-CHOP therapy: a single-institution study in China

Objective: To develop a prognostic model for Chinese patients with relapsed diffuse large B-cell lymphoma (DLBCL) after initial R-CHOP therapy.

Methods: We retrospectively analyzed the characteristics and survival outcomes of 79 patients with relapsed DLBCL initially treated with R-CHOP at Peking Union Medical College Hospital from February 2012 to September 2016. We used the data to develop a novel prognostic model.

Results: The median age at the start of salvage therapy was 59 (17-85) years and median time from diagnosis to relapse was 319 (49-1018) days. Multivariate analysis identified short time to relapse (TTR) and B symptoms as independent prognostic factors for reduced progression-free survival (PFS) and overall survival (OS). We created a new prognostic scoring system including TTR, lactate dehydrogenase, absolute lymphocyte count at relapse, and B symptoms, referred to as the TLLB model, which could separate patients into three risk groups with 2-year PFS and OS rates of 70.7%, 40.0%, and 11.1%, and 87.5%, 53.7%, and 29.4%, respectively.

Conclusion: TTR and B symptoms can be used as important predictors of survival in patients with DLBCL. The TLLB system provides a useful prognostic model compared with the previous TTL system.