Risk factors of relapsed or refractory of the treatment of diffuse large B-cell lymphoma in Chiangrai Prachanukroh Hospital
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Abstract
Risk factors of relapsed or refractory of the treatment of diffuse large B-cell lymphoma in Chiangrai Prachanukroh Hospital
Piyapong Kanya,MD., Piyaporn, Sirijanchune, MD., Nonlawan Chueamuangphan, MD., Ph.D.
ABSTRACT
BACKGROUND
Diffuse large B-cell lymphoma (DLBCL) is the most common lymphoma in Thailand. One-third of patients had a condition either refractory to initial treatment or relapse after standard regimen.
OBJECTIVES
Primary outcome was risk factors of relapsed or refractory of DLBCL with a standard treatment regimen. Secondary outcomes were 3-year overall survival (OS) of DLBCL and lymphoma incidence characteristic patterns defined by the World Health Organization (WHO) 2008 subtype.
METHODS
A retrospective cohort study of DLBCL patients at Chiangrai Prachanukroh Hospital from January 2013 to December 2019. Data collection was reviewed from medical records. The cox proportional hazards models were used to estimate the hazard ratio and 95% confidence intervals (CI) associated with the risk factors of relapsed or refractory DLBCL. P-value < 0.05 was considered statistically significant.
RESULTS
There were 101 patients with DLBCL with a mean age of 58.82 years. Forty-one patients (40.59%) had a condition of relapsed or refractory DLBCL. The risk factors of relapsed or refractory DLBCL were Ann Arbor stage III-IV (HR 2.21; 95% CI 1.06-4.62, p=0.035) and elevated lactate dehydrogenase (LDH) level [hazard ratio (HR) 4.01; 95% CI 1.66-9.68, p=0.002]. Patients with Ann Arbor stages I-II had better 3-year OS compared to Ann Arbor stage III-IV (74% and 46% respectively, p=0.005). Patients with normal serum LDH had better 3-year OS compared to high serum LDH (75% and 52% respectively, p=0.008). The common lymphoma incidence characteristic patterns defined by WHO 2008 subtype were DLBCL, Extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue [MALT-lymphoma] and Peripheral T-cell lymphoma, not otherwise specified (PTCL, NOS) (51.80%, 9.23%, and 6.15% respectively).
CONCLUSIONS AND DISCUSSIONS
The risk factors of relapsed or refractory of DLBCL treatment were Ann Arbor stage III-IV and elevated LDH level. The evaluation of Ann Arbor staging and serum LDH were essential categories to predict prognosis and treatment outcome.
KEYWORDS: Relapsed or refractory DLBCL, Risk factors, LDH, Ann Arbor staging.
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References
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