e20076 Background: Classification of diffuse large B cell lymphoma (DLBCL) takes into consideration - cell of origin, germinal center B-cell (GCB) vs non germinal center/activated B-cell type (non-GCB/ABC), since its determination by gene expression profiling predicts prognosis when treated with standard therapy. In this report we evaluated impact of choice of therapy and stem cell transplant (SCT) on the outcome of GBC and ABC subtype determined by immunohistochemistry (IHC) using Hans algorithm. Methods: We reviewed pathology reports DLBCL patients diagnosed from 2009 - 2016. For GCB and non-GCB/ABC patients data was collected including demographics, stage, initial and subsequent chemo, response and SCT. Results: Out of total 267 patients with DLBCL Per Hans algorithm, 117 (43.8%) were GCB, 94 (35.2%) ABC. GCB group - Median age at diagnosis was 65 years. 65% were older than 60 years. 27% Double expressors (DE). Frontline therapy was R-CHOP in 67.5% patients. 38% received other chemo - BR, hyperCVAD, RICE, RCVP. 26% patients had multiple lines of treatment. Average duration of first remission was 2.6 years. Complete response (CR) was achieved in 53% patients. Partial response (PR) in 27%. Median survival was 84.8 months. 12% underwent SCT. After SCT - 8 achieved CR, 3 PR, and 1 in PD. ABC group - Median age at diagnosis was 67 years. 67% were older than 60 years. DE were 19%. Frontline therapy was R-CHOP in 78% patients. 20% received other chemo. 21% needed multiple lines of treatment. CR was achieved in 76%. Median survival was 59.2 month. Median duration of remission for patients who received R-CHOP was 2 years and 1.25 years for other chemo. 7.4% had SCT - 5 auto and 2 allo. Conclusions: GCB and non-GCB/ABC DLBCL identified by IHC who received R-CHOP as induction had better outcome than who received other chemo. GCB had better overall survival compared to non-GCB/ABC. Median duration of first remission was 2 to 2.6 years and 30% patients received multiple lines of therapy. Only 15% patients underwent SCT – 66% achieved CR in GCB and 85% in ABC. Clinical trials adding newer agents and better stratifying patients who benefit from SCT are warranted. [Table: see text]
Recurrent Diffuse Large B-Cell Lymphoma Germinal Center B-Cell Type