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Article

The Prognostic Impact of Comorbidities in Patients with De-Novo Diffuse Large B-Cell Lymphoma Treated with R-CHOP Immunochemotherapy in Curative Intent

1
Department of Internal Medicine V (Hematology and Oncology), Innsbruck Medical University, 6020 Innsbruck, Austria
2
Department of Hematology & CBMT, Central Hospital of Bolzano (SABES-ASDAA), 39100 Bolzano-Bozen, Italy
3
Riga Stradiņš University, 1007 Riga, Latvia
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(4), 1005; https://doi.org/10.3390/jcm9041005
Received: 21 March 2020 / Revised: 29 March 2020 / Accepted: 31 March 2020 / Published: 2 April 2020
(This article belongs to the Section Hematology)
Background: Patient-related factors, namely comorbidities, impact the clinical outcome of patients with diffuse large B-cell lymphoma (DLBCL). Methods: The prevalence and prognostic impact of comorbidities were examined using the validated scores Charlson Comorbidity Index (CCI) and Hematopoietic Cell Transplantation-specific Comorbidity Index (HCT-CI) in 181 patients with DLBCL at initial diagnosis before treatment with rituximab, cyclophosphamide, vincristine, doxorubicin and prednisone (R-CHOP). Results: Pronounced comorbidities as defined by CCI and HCT-CI scoring of ≥2 were detected in 9.9% and 28.2% of patients, respectively, and occurred more frequently at advanced age (p < 0.001). Higher CCI scoring was associated with lower complete response rate (p = 0.020). Both advanced CCI and HCT-CI were significantly associated with shortened overall survival (3-year OS: CCI ≥2 vs. 0–1, 38.9% vs. 81.3%, p < 0.001; HCT-CI ≥2 vs. 0–1, 56.9% vs. 84.9%, p < 0.001). Both comorbidity scores remained independent risk factors in the multivariate analysis (HCT-CI ≥2 HR: 2.6, p = 0.004; CCI ≥2 HR: 3.6, p = 0.001). Conclusion: This study demonstrates the prognostic relevance of comorbidities classified by CCI and HCT-CI in patients with DLBCL undergoing curative treatment with R-CHOP. A structured evaluation of comorbidities might refine prognostication alongside currently used prognostic parameters, namely age, and should be evaluated in prospective trials. View Full-Text
Keywords: comorbidities; HCT-CI; CCI; DLBCL; prognosis; R-CHOP comorbidities; HCT-CI; CCI; DLBCL; prognosis; R-CHOP
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MDPI and ACS Style

Kocher, F.; Mian, M.; Seeber, A.; Fiegl, M.; Stauder, R. The Prognostic Impact of Comorbidities in Patients with De-Novo Diffuse Large B-Cell Lymphoma Treated with R-CHOP Immunochemotherapy in Curative Intent. J. Clin. Med. 2020, 9, 1005. https://doi.org/10.3390/jcm9041005

AMA Style

Kocher F, Mian M, Seeber A, Fiegl M, Stauder R. The Prognostic Impact of Comorbidities in Patients with De-Novo Diffuse Large B-Cell Lymphoma Treated with R-CHOP Immunochemotherapy in Curative Intent. Journal of Clinical Medicine. 2020; 9(4):1005. https://doi.org/10.3390/jcm9041005

Chicago/Turabian Style

Kocher, Florian, Michael Mian, Andreas Seeber, Michael Fiegl, and Reinhard Stauder. 2020. "The Prognostic Impact of Comorbidities in Patients with De-Novo Diffuse Large B-Cell Lymphoma Treated with R-CHOP Immunochemotherapy in Curative Intent" Journal of Clinical Medicine 9, no. 4: 1005. https://doi.org/10.3390/jcm9041005

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