Clinical outcomes in patients with diffuse large B cell lymphoma with a partial response to first-line R-CHOP chemotherapy: prognostic value of secondary International Prognostic Index scores and Deauville scores

Hyewon Lee, Yu Ri Kim, Soo Jeong Kim, Yong Park, Hyeon Seok Eom, Sung Yong Oh, Hyo Jung Kim, Hye Jin Kang, Won Sik Lee, Joon Ho Moon, Young-Woong Won, Tae Sung Kim, Jin Seok Kim

Research output: Contribution to journalArticle

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Abstract

After introducing a rituximab-containing chemoimmunotherapy (R-CHOP) for diffuse large B cell lymphoma (DLBCL), a partial response (PR) which is regarded as treatment failure is still observed. To investigate the prognostic factors for the DLBCL patients with a PR to R-CHOP, we retrospectively evaluated 758 newly diagnosed DLBCL patients. After R-CHOP, 88 (11.6%) achieved a PR. Three-year progression-free and overall survival rates measured from the date of PR achievement (PFS2 and OS2) were 57.4 and 67.8%, respectively. The secondary International Prognostic Index (IPI2) scores after R-CHOP were low (0–1) in 68.2% and high (2–3) in 31.8% of the patients. The Deauville scores from 18-fluorodeoxyglucose positron emission tomography after R-CHOP showed low (2–3) in 58.0% and high (4) in 42.0% of the patients. High IPI2 and high Deauville scores were associated with worse PFS2 (P < 0.001 and P = 0.009) and OS2 (P = 0.013 and P = 0.067). The high-risk group defined by the IPI2 and Deauville scores, whose scores were both high, showed significantly lower 3-year PFS2 (P < 0.001) and OS2 (P = 0.006) rates compared with those of the other groups. In multivariate analyses, the IPI score of ≥ 3 at diagnosis and bone marrow involvement at diagnosis were independent prognostic factors. In addition, high IPI2-Deauville score after R-CHOP was significantly associated with poor PFS2 (P = 0.009) and demonstrated a trend toward inferior OS2. In conclusion, DLBCL patients who partially responded to R-CHOP are still a heterogeneous group, for which IPI2 and Deauville scores should be evaluated for prediction of prognosis.

Original languageEnglish
Pages (from-to)1873-1881
Number of pages9
JournalAnnals of Hematology
Volume96
Issue number11
DOIs
StatePublished - 2017 Nov 1

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Lymphoma, Large B-Cell, Diffuse
Drug Therapy
Rituximab
Treatment Failure
Positron-Emission Tomography
Disease-Free Survival
Multivariate Analysis
Survival Rate
Bone Marrow

Keywords

  • Deauville scores
  • Diffuse large B cell lymphoma
  • FDG-PET
  • International Prognostic Index
  • Partial response

Cite this

Lee, Hyewon ; Kim, Yu Ri ; Kim, Soo Jeong ; Park, Yong ; Eom, Hyeon Seok ; Oh, Sung Yong ; Kim, Hyo Jung ; Kang, Hye Jin ; Lee, Won Sik ; Moon, Joon Ho ; Won, Young-Woong ; Kim, Tae Sung ; Kim, Jin Seok. / Clinical outcomes in patients with diffuse large B cell lymphoma with a partial response to first-line R-CHOP chemotherapy : prognostic value of secondary International Prognostic Index scores and Deauville scores. In: Annals of Hematology. 2017 ; Vol. 96, No. 11. pp. 1873-1881.
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title = "Clinical outcomes in patients with diffuse large B cell lymphoma with a partial response to first-line R-CHOP chemotherapy: prognostic value of secondary International Prognostic Index scores and Deauville scores",
abstract = "After introducing a rituximab-containing chemoimmunotherapy (R-CHOP) for diffuse large B cell lymphoma (DLBCL), a partial response (PR) which is regarded as treatment failure is still observed. To investigate the prognostic factors for the DLBCL patients with a PR to R-CHOP, we retrospectively evaluated 758 newly diagnosed DLBCL patients. After R-CHOP, 88 (11.6{\%}) achieved a PR. Three-year progression-free and overall survival rates measured from the date of PR achievement (PFS2 and OS2) were 57.4 and 67.8{\%}, respectively. The secondary International Prognostic Index (IPI2) scores after R-CHOP were low (0–1) in 68.2{\%} and high (2–3) in 31.8{\%} of the patients. The Deauville scores from 18-fluorodeoxyglucose positron emission tomography after R-CHOP showed low (2–3) in 58.0{\%} and high (4) in 42.0{\%} of the patients. High IPI2 and high Deauville scores were associated with worse PFS2 (P < 0.001 and P = 0.009) and OS2 (P = 0.013 and P = 0.067). The high-risk group defined by the IPI2 and Deauville scores, whose scores were both high, showed significantly lower 3-year PFS2 (P < 0.001) and OS2 (P = 0.006) rates compared with those of the other groups. In multivariate analyses, the IPI score of ≥ 3 at diagnosis and bone marrow involvement at diagnosis were independent prognostic factors. In addition, high IPI2-Deauville score after R-CHOP was significantly associated with poor PFS2 (P = 0.009) and demonstrated a trend toward inferior OS2. In conclusion, DLBCL patients who partially responded to R-CHOP are still a heterogeneous group, for which IPI2 and Deauville scores should be evaluated for prediction of prognosis.",
keywords = "Deauville scores, Diffuse large B cell lymphoma, FDG-PET, International Prognostic Index, Partial response",
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Clinical outcomes in patients with diffuse large B cell lymphoma with a partial response to first-line R-CHOP chemotherapy : prognostic value of secondary International Prognostic Index scores and Deauville scores. / Lee, Hyewon; Kim, Yu Ri; Kim, Soo Jeong; Park, Yong; Eom, Hyeon Seok; Oh, Sung Yong; Kim, Hyo Jung; Kang, Hye Jin; Lee, Won Sik; Moon, Joon Ho; Won, Young-Woong; Kim, Tae Sung; Kim, Jin Seok.

In: Annals of Hematology, Vol. 96, No. 11, 01.11.2017, p. 1873-1881.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Clinical outcomes in patients with diffuse large B cell lymphoma with a partial response to first-line R-CHOP chemotherapy

T2 - prognostic value of secondary International Prognostic Index scores and Deauville scores

AU - Lee, Hyewon

AU - Kim, Yu Ri

AU - Kim, Soo Jeong

AU - Park, Yong

AU - Eom, Hyeon Seok

AU - Oh, Sung Yong

AU - Kim, Hyo Jung

AU - Kang, Hye Jin

AU - Lee, Won Sik

AU - Moon, Joon Ho

AU - Won, Young-Woong

AU - Kim, Tae Sung

AU - Kim, Jin Seok

PY - 2017/11/1

Y1 - 2017/11/1

N2 - After introducing a rituximab-containing chemoimmunotherapy (R-CHOP) for diffuse large B cell lymphoma (DLBCL), a partial response (PR) which is regarded as treatment failure is still observed. To investigate the prognostic factors for the DLBCL patients with a PR to R-CHOP, we retrospectively evaluated 758 newly diagnosed DLBCL patients. After R-CHOP, 88 (11.6%) achieved a PR. Three-year progression-free and overall survival rates measured from the date of PR achievement (PFS2 and OS2) were 57.4 and 67.8%, respectively. The secondary International Prognostic Index (IPI2) scores after R-CHOP were low (0–1) in 68.2% and high (2–3) in 31.8% of the patients. The Deauville scores from 18-fluorodeoxyglucose positron emission tomography after R-CHOP showed low (2–3) in 58.0% and high (4) in 42.0% of the patients. High IPI2 and high Deauville scores were associated with worse PFS2 (P < 0.001 and P = 0.009) and OS2 (P = 0.013 and P = 0.067). The high-risk group defined by the IPI2 and Deauville scores, whose scores were both high, showed significantly lower 3-year PFS2 (P < 0.001) and OS2 (P = 0.006) rates compared with those of the other groups. In multivariate analyses, the IPI score of ≥ 3 at diagnosis and bone marrow involvement at diagnosis were independent prognostic factors. In addition, high IPI2-Deauville score after R-CHOP was significantly associated with poor PFS2 (P = 0.009) and demonstrated a trend toward inferior OS2. In conclusion, DLBCL patients who partially responded to R-CHOP are still a heterogeneous group, for which IPI2 and Deauville scores should be evaluated for prediction of prognosis.

AB - After introducing a rituximab-containing chemoimmunotherapy (R-CHOP) for diffuse large B cell lymphoma (DLBCL), a partial response (PR) which is regarded as treatment failure is still observed. To investigate the prognostic factors for the DLBCL patients with a PR to R-CHOP, we retrospectively evaluated 758 newly diagnosed DLBCL patients. After R-CHOP, 88 (11.6%) achieved a PR. Three-year progression-free and overall survival rates measured from the date of PR achievement (PFS2 and OS2) were 57.4 and 67.8%, respectively. The secondary International Prognostic Index (IPI2) scores after R-CHOP were low (0–1) in 68.2% and high (2–3) in 31.8% of the patients. The Deauville scores from 18-fluorodeoxyglucose positron emission tomography after R-CHOP showed low (2–3) in 58.0% and high (4) in 42.0% of the patients. High IPI2 and high Deauville scores were associated with worse PFS2 (P < 0.001 and P = 0.009) and OS2 (P = 0.013 and P = 0.067). The high-risk group defined by the IPI2 and Deauville scores, whose scores were both high, showed significantly lower 3-year PFS2 (P < 0.001) and OS2 (P = 0.006) rates compared with those of the other groups. In multivariate analyses, the IPI score of ≥ 3 at diagnosis and bone marrow involvement at diagnosis were independent prognostic factors. In addition, high IPI2-Deauville score after R-CHOP was significantly associated with poor PFS2 (P = 0.009) and demonstrated a trend toward inferior OS2. In conclusion, DLBCL patients who partially responded to R-CHOP are still a heterogeneous group, for which IPI2 and Deauville scores should be evaluated for prediction of prognosis.

KW - Deauville scores

KW - Diffuse large B cell lymphoma

KW - FDG-PET

KW - International Prognostic Index

KW - Partial response

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