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