Relapse and refractory (R/R) rates after first-line R-CHOP in diffuse large B cell lymphomas (DLBCL) are ~40% and ~15% respectively. We conducted a retrospective real- world analysis aimed at evaluating clinical outcomes of R/R DLBCL patients. Overall, 403 consecutive DLBCL patients treated in two large hematological centers in Torino, Italy were reviewed. At a median follow up of 50 months, 5-year overall survival from diagnosis (OS-1) was 66.5%, and 2-year progression free survival (PFS-1) was 68%. Overall, 134 (34.4%) patients relapsed (n=46, 11.8%) or were refractory (n=88, 22.6%) to R-CHOP. Most employed salvage treatments included platinum salt-based regimens in 38/134 (28.4%), lenalidomide in 14 (10.4%). Median OS and PFS after disease relapse or progression (OS- 2 and PFS-2) were 6.7 and 5.1 months respectively. No significant difference in overall response rate, OS-2 or PFS-2 in patients treated with platinum-based regimens vs. other regimens was observed. By multivariate analysis, age between 60 and 80 years, germinal center B cell type cell of origin and extranodal involvement of <2 sites were associated with better OS-2. Our findings confirm very poor outcomes of R/R DLBCL in the rituximab era. Widespread approval by national Medicine Agencies of novel treatments such as CAR-T cells and bispecific antibodies as second-line is eagerly awaited to improve these outcomes.
Real life clinical outcomes of relapsed/refractory diffuse large B cell lymphoma in the rituximab era: the STRIDER study
Veronica Peri;Davide Musto;Silvio Mercadante;Simone Ragaini;Mario Levis;Umberto Mortara;Chiara Consoli;Alessio Lonardo;Giulia Bondielli;Simone Ferrero;Umberto Ricardi;Benedetto Bruno;Federica Cavallo
2024-01-01
Abstract
Relapse and refractory (R/R) rates after first-line R-CHOP in diffuse large B cell lymphomas (DLBCL) are ~40% and ~15% respectively. We conducted a retrospective real- world analysis aimed at evaluating clinical outcomes of R/R DLBCL patients. Overall, 403 consecutive DLBCL patients treated in two large hematological centers in Torino, Italy were reviewed. At a median follow up of 50 months, 5-year overall survival from diagnosis (OS-1) was 66.5%, and 2-year progression free survival (PFS-1) was 68%. Overall, 134 (34.4%) patients relapsed (n=46, 11.8%) or were refractory (n=88, 22.6%) to R-CHOP. Most employed salvage treatments included platinum salt-based regimens in 38/134 (28.4%), lenalidomide in 14 (10.4%). Median OS and PFS after disease relapse or progression (OS- 2 and PFS-2) were 6.7 and 5.1 months respectively. No significant difference in overall response rate, OS-2 or PFS-2 in patients treated with platinum-based regimens vs. other regimens was observed. By multivariate analysis, age between 60 and 80 years, germinal center B cell type cell of origin and extranodal involvement of <2 sites were associated with better OS-2. Our findings confirm very poor outcomes of R/R DLBCL in the rituximab era. Widespread approval by national Medicine Agencies of novel treatments such as CAR-T cells and bispecific antibodies as second-line is eagerly awaited to improve these outcomes.
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