Do Double-Expressor High-Grade B-Cell Lymphomas Really Need Intensified Treatment? A Report from the Real-Life Series of High-Grade B-Cell Lymphomas Treated with Different Therapeutic Protocols at the Institute of Oncology Ljubljana
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patients
2.2. Pathohistological Examination
2.3. Statistical Analyses
3. Results
3.1. Demographic Data
3.2. Treatment
3.3. Survival
3.3.1. Double-Expressor Group
3.3.2. Double- and Triple-Hit Group
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Number of Patients | The Whole Cohort (N = 154) | DE DLBCL Patients (N = 122) | DHL/THL Patients (N = 16) |
---|---|---|---|
Male/Female | 79 (51.3%)/75 (48.7%) | 60 (49.2%)/62 (50.8%) | 11 (68.8%)/5 (31.2%) |
Median age at diagnosis | 70 years (range 21–91 years) | 70 years (range 21–89 years) | 67 years (range 23–87 years) |
Median stage at diagnosis | 4 (range 1–4) | 4 (range 1–4) | 4 (range 1–4) |
Constitutional symptoms | 66 patients (42.9%) | 54 patients (44.3%) | 9 patients (56.2%) |
Bulky disease | 28 patients (18.2%) | 20 patients (16.4%) | 5 patients (31.2%) |
Extranodal involvement | 74 patients (48.0%) | 56 patients (45.9%) | 9 patients (56.2%) |
Elevated LDH level | 86 patients (55.8%) | 68 patients (55.7%) | 12 patients (75.0%) |
Low-risk IPI score (0, 1 points) | 39 patients (25.4%) | 31 patients (25.4%) | 4 patients (25.0%) |
Low-intermediate-risk IPI score (2 points) | 27 patients (17.5%) | 23 patients (18.8%) | 1 patient (6.2%) |
High-intermediate-risk IPI score (3 points) | 31 patients (20.1%) | 24 patients (19.7%) | 4 patients (25.0%) |
High-risk IPI score (4, 5 points) | 57 patients (37.0%) | 44 patients (36.1%) | 7 patients (43.8%) |
Therapeutic Group | Therapeutic Regimen Used | Number of Patients (N = 154) | DE DLBCL Patients (N = 122) | DHL/THL Patients (N = 16) |
---|---|---|---|---|
Group A | R-CHOP | 109 (70.8%) | 100 (81.9%) | 9 (58.8%) |
Group B | R-CHOP + intermediate-dose MTX | 10 (6.5%) | 8 (6.6%) | 2 (11.8%) |
Group C | R-DA-EPOCH | 19 (12.3%) | 14 (11.5%) | 5 (29.4%) |
Group D | R-COEP, GemOx, R-CBVPP | 16 (10.4%) | 13 (excluded from the 135-patient primary group) | 3 (excluded from the 19-patient primary group) |
All Patients (N = 154) | DE DLBCL Patients (N = 122) | DHL/THL Patients (N = 16) | |
---|---|---|---|
Median number of cycles | 6 (range 1–8) | 6 (range 1–8) | 6 (range 1–8) |
Radiotherapy consolidation | 59 (59/154 = 38.3%) | 46 (46/122 = 37.7%) | 7 (7/16 = 43.8%) |
Outcome: complete remission (CR) | 118 (118/154 = 76.6%) | 101 (101/122 = 82.8%) | 9 (9/16 = 56.4%) |
Outcome: partial remission (PR) | 6 (6/154 = 3.9%) | 4 (4/122 = 3.3%) | 1 (1/16 = 6.2%) |
Outcome: stable disease (SD) | 1 (1/154 = 0.7%) | 0 (0%) | 0 (0%) |
Outcome: progressive disease (PD) | 19 (19/154 = 12.3%) | 13 (13/122 = 10.6%) | 3 (3/16 = 18.7%) |
Treatment outcome was not evaluated † | 10 (10/154 = 6.5%) | 4 (4/122 = 3.3%) | 3 (3/16 = 18.7%) |
Therapeutic Group | Therapeutic Regimen | Number of DE DLBCL Patients (N = 122) | Median IPI Value | Median Age at Diagnosis | Received CNS Prophylaxis | Progression of Lymphoma | Progression into CNS | Died/Due to Lymphoma |
---|---|---|---|---|---|---|---|---|
Group A | R-CHOP | 100 | 3 | 70 (range 21–89) | 44 (44/100 = 44.0%) | 20 (20/100 = 20.0%) | 6 (6/20 = 30.0%) | 27 (27/100 = 27.0%)/19 (19/27 = 70.4%) |
Group B | R-CHOP + intermediate-dose MTX | 8 | 3.5 | 64 (range 38–71) | 8 (8/8 = 100%) | 2 (2/8 = 25.0%) | 1 (1/2 = 50.0%) | 2 (2/8 = 25.0%)/1 (1/2 = 50.0%) |
Group C | R-DA-EPOCH | 14 | 3 | 57 (range 48–75) | 9 (9/14 = 64.3%) | 2 (2/14 = 14.3%) | 0 | 3 (3/14 = 21.4%)/3 (3/3 = 100%) |
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Boltežar, L.; Rožman, S.; Gašljević, G.; Grčar Kuzmanov, B.; Jezeršek Novaković, B. Do Double-Expressor High-Grade B-Cell Lymphomas Really Need Intensified Treatment? A Report from the Real-Life Series of High-Grade B-Cell Lymphomas Treated with Different Therapeutic Protocols at the Institute of Oncology Ljubljana. Biomedicines 2024, 12, 275. https://doi.org/10.3390/biomedicines12020275
Boltežar L, Rožman S, Gašljević G, Grčar Kuzmanov B, Jezeršek Novaković B. Do Double-Expressor High-Grade B-Cell Lymphomas Really Need Intensified Treatment? A Report from the Real-Life Series of High-Grade B-Cell Lymphomas Treated with Different Therapeutic Protocols at the Institute of Oncology Ljubljana. Biomedicines. 2024; 12(2):275. https://doi.org/10.3390/biomedicines12020275
Chicago/Turabian StyleBoltežar, Lučka, Samo Rožman, Gorana Gašljević, Biljana Grčar Kuzmanov, and Barbara Jezeršek Novaković. 2024. "Do Double-Expressor High-Grade B-Cell Lymphomas Really Need Intensified Treatment? A Report from the Real-Life Series of High-Grade B-Cell Lymphomas Treated with Different Therapeutic Protocols at the Institute of Oncology Ljubljana" Biomedicines 12, no. 2: 275. https://doi.org/10.3390/biomedicines12020275