Desai Sanjal, Chaturvedi Mansi, Hameed Rumaisa, Baez-Sosa Valentina, Shenoy Aarthi G
Department of Hematology and Medical Oncology, Medstar Washington Hospital Center, Washington, DC, USA.
Department of Hematology, Mayo Clinic, Rochester, Minnesota, USA.
Oncologist. 2021 Sep;26(9):e1660-e1663. doi: 10.1002/onco.13846. Epub 2021 Jun 14.
Outcomes of diffuse large B-cell lymphoma (DLBCL), either concurrent with or transformed from indolent lymphoma, treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone are described in retrospective studies. The efficacy of other regimens in transformed or concurrent DLBCL is largely unknown. In this single-center retrospective study, we present characteristics of concurrent and transformed DLBCL and outcomes after dose-adjusted etoposide, vincristine, cyclophosphamide, prednisone, and doxorubicin with rituximab (DA-EPOCH-R) comparative with de novo DLBCL. Of 170 patients with DLBCL, 136 were de novo, 17 were concurrent, and 17 were transformed. Transformed DLBCL had significantly lower complete response rates and progression-free survival (PFS) but similar overall survival (OS) compared with de novo counterpart. There was no significant difference between de novo and concurrent DLBCL regarding response rates, PFS, and OS. DA-EPOCH-R was associated with inferior OS. Thus, intensified treatment with DA-EPOCH-R might not improve outcomes of transformed DLBCL.
回顾性研究描述了利妥昔单抗、环磷酰胺、多柔比星、长春新碱和泼尼松治疗的与惰性淋巴瘤同时存在或由惰性淋巴瘤转化而来的弥漫性大B细胞淋巴瘤（DLBCL）的预后。其他方案在转化型或同时存在的DLBCL中的疗效很大程度上未知。在这项单中心回顾性研究中，我们呈现了同时存在和转化型DLBCL的特征以及与原发性DLBCL相比，剂量调整的依托泊苷、长春新碱、环磷酰胺、泼尼松和多柔比星联合利妥昔单抗（DA-EPOCH-R）治疗后的预后。在170例DLBCL患者中，136例为原发性，17例为同时存在型，17例为转化型。与原发性DLBCL相比，转化型DLBCL的完全缓解率和无进展生存期（PFS）显著更低，但总生存期（OS）相似。原发性和同时存在型DLBCL在缓解率、PFS和OS方面无显著差异。DA-EPOCH-R与较差的OS相关。因此，用DA-EPOCH-R进行强化治疗可能无法改善转化型DLBCL的预后。
