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Cancer Research and Treatment > Accepted Articles
doi: https://doi.org/10.4143/crt.2022.008    [Accepted]
Outcomes in Refractory Diffuse Large B-Cell Lymphoma: Results from Two Prospective Korean Cohorts
Jun Ho Yi1 , Seong Hyun Jeong2, Seok Jin Kim3, Dok Hyun Yoon4, Hye Jin Kang5, Youngil Koh6, Jin Seok Kim7, Won-Sik Lee8, Deok-Hwan Yang9, Young Rok Do10, Min Kyoung Kim11, Kwai Han Yoo12, Yoon Seok Choi2, Whan Jung Yun13, Yong Park14, Jae-Cheol Jo15, Hyeon-Seok Eom16, Jae-Yong Kwak17, Ho-Jin Shin18, Byeong Bae Park19, Seong Yoon Yi20, Ji-Hyun Kwon21, Sung Yong Oh22, Hyo Jung Kim23, Byeong Seok Sohn24, Jong Ho Won25, Dae-Sik Hong26, Ho-Sup Lee27, Gyeong-Won Lee28, Cheolwon Suh4, Won Seog Kim3
1Department of Internal Medicine, Chung-Ang University Hospital, Seoul, Korea
2Department of Hematology-Oncology, Ajou University School of Medicine, Suwon, Korea
3Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
4Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
5Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea
6Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
7Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
8Department of Internal Medicine, Inje University Busan Paik Hospital, Busan, Korea
9Department of Internal Medicine, Chonnam National University Hwasun Hospital, Hwasun, Korea
10Department of Internal Medicine, Dongsan Medical Center, Daegu, Korea
11Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
12Department of Internal Medicine, Gachon University College of Medicine, Incheon, Korea
13Department of Internal Medicine, Chonnam National University Hospital, Daejeon, Korea
14Department of Internal Medicine, Korea University Anam Hospital, Seoul, Korea
15Department of Hematology and Oncology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
16Hematology-Oncology Clinic, National Cancer Center, Goyang, Korea
17Department of Internal Medicine, Jeonbuk National University Medical School, Jeonju, Korea
18Department of Internal Medicine, Pusan National University Hospital, Busan, Korea
19Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
20Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea
21Department of Internal Medicine, Chungbuk National University Hospital, Chungju, Korea
22Department of Internal Medicine, Dong-A University Medical Center, Busan, Korea
23Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Korea
24Department of Internal Medicine, Inje University Sanggye Paik Hospital, Seoul, Korea
25Department of Hematology-Oncology, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
26Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
27Department of Internal Medicine, Kosin University Gospel Hospital, Busan, Korea
28Department of Internal Medicine, Gyeongsang National University Hospital, Jinju, Korea
Correspondence  Won Seog Kim ,Tel: 82-2-3410-6548, Fax: 82-2-3410-1754, Email: wskimsmc@skku.edu
Received: January 4, 2022;  Accepted: April 21, 2022.  Published online: April 22, 2022.
ABSTRACT
Purpose
Diffuse large B-cell lymphoma (DLBCL) is the most common hematologic malignancy worldwide. Although substantial improvement has been achieved by the frontline rituximab-based chemoimmunotherapy, up to 40~50% of patients will eventually have relapsed or refractory disease, whose prognosis is extremely dismal.
Materials and Methods
We have carried out two prospective cohort studies that include over 1,500 DLBCL patients treated with rituximab plus CHOP (#NCT01202448 and #NCT02474550). In the current report, we describe the outcomes of refractory DLBCL patients. Patients were defined to have refractory DLBCL if they met one of the followings, 1) not achieving at least partial response after four or more cycles of R-CHOP; 2) not achieving at least partial response after two or more cycles of salvage therapy; 3) progressive disease within 12 months after autologous stem cell transplantation.
Results
Among 1,581 patients, a total of 260 patients met the criteria for the refractory disease after a median time to progression of 9.1 months. The objective response rate of salvage treatment was 26.4%, and the complete response rate was 9.6%. The median OS was 7.5 months (95% CI 6.4 – 8.6), and the 2-year survival rate was 22.1% ± 2.8%. The median OS for each refractory category was not significantly different (p=0.529).
Conclusion
In line with the previous studies, the outcomes of refractory DLBCL patients were extremely poor, which necessitates novel approaches for this population.
Key words: Diffuse large B-cell lymphoma, Refractory, Clinical outcomes
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