scholarly journals Clinicopathological Correlation with Outcome of Diffuse Large B Cell Lymphoma: Experience in a Specialized Cancer Care Centre in Bangladesh

2021 ◽  
Vol 22 (1) ◽  
pp. 3-6
Author(s):  
Tamanna Bahar ◽  
Zulfia Zinat Chowdhury ◽  
Shaila Rahman ◽  
Salina Haque ◽  
AKM Mynul Islam ◽  
...  
Keyword(s):  
Retrospective Study ◽  
B Cell ◽  
Cancer Care ◽  
Response Rate ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Care Centre ◽  
Large B Cell Lymphoma ◽  
Significant Difference ◽  
Large B Cell

Background: Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma (NHL) in the world, and accounts for 30%–40% of all adult NHLs. It is clinically, morphologically and genetically a heterogeneous group of tumors composed of large B cells. This study aimed to determine the clinical features, treatment options, the response rate in a specialized cancer care centre. Methods: This retrospective study included all DLBCL patients registered in the department of Haematology of National Institute of Cancer Research and Hospital (NICR&H), Bangladesh between July 2016 to June 2019. Results: A total of 151cases were included in this study. The mean age was 47 years with a standard deviation (SD) of 15 years. Males (66.2%) were more in the occurrence of DLBCL. We divided the cases into three different entities of DLBCL and non-germinal centre B (non-GCB) variety was the prevalent (46.4%) one. Several types of first-line chemotherapy were used in management and the overall response rate (ORR) was 76.6% and 9.2% of death. The response was found to be significant with B symptoms, stage, and international prognostic index (IPI) score. But no significant difference was observed in outcome among different types of DLBCL after treatment. Conclusion: This retrospective study will help to ascertain the co relation of DLBCL outcome with clinicopathological profile. (edited) J MEDICINE JAN 2021; 22 (1) : 3-6

scholarly journals Diffuse large B-cell lymphoma: An institutional analysis

2018 ◽  
Vol 07 (03) ◽  
pp. 200-202 ◽  
Author(s):  
Ajay Gogia ◽  
Chandan K. Das ◽  
Lalit Kumar ◽  
Atul Sharma ◽  
Akash Tiwari ◽  
...  
Keyword(s):  
Retrospective Study ◽  
High Risk ◽  
B Cell ◽  
Response Rate ◽  
Cell Lymphoma ◽  
Prognostic Index ◽  
B Cell Lymphoma ◽  
Cell Of Origin ◽  
Large B Cell Lymphoma ◽  
Large B Cell

Abstract Introduction: Diffuse large B-cell lymphoma (DLBCL) is the most common subtype of non-Hodgkin's lymphoma. We conducted a retrospective study to analyze the clinicopathological characteristics, cell of origin, response to therapy, and the outcome of patients with DLBCL. Materials and Methods: This was a retrospective study which included all patients with DLBCL registered at our center, between May 1, 2013, and July 31, 2015. The data regarding demography, clinical presentation, histopathology, stage, prognostic index, treatment, and treatment-related outcome were collected from prospectively maintained clinical case records of the patients. Results: In the study, we included 267 patients. The median age is 49 (20–81) years with male: female ratio of 2:1. B symptoms were seen in 124 (45%) of patients. Early Stages (I and II) were seen in 130 (52%) patients, while advanced Stages (III and 1V) were seen in 119 (48%) patients. Bulky disease (>7.5 cm) was seen in 30% of cases, and bone marrow was involved in 12%. Extranodal involvement is present in 35% of cases. Cell of origin data was available in 160 (60%) of cases, of which 88 (55%) were germinal center and 72 (45%) were activated B cell in origin. The distribution according to the international prognostic index (IPI) was as follows: low risk 40%, intermediate risk 45%, and high risk in 15%. Rituximab was used in 45% of cases. The overall response rate was 84% with a complete response (CR) rate of 70.5%. The CR rates were better with RCHOP compared with CHOP (77% vs. 61.5%, P = 0.001) and good-risk IPI (83.3% vs. 65.2%, P < 0.001) compared with intermediate- and high-risk IPI. Median follow-up period was 24 months, and 2-year event-free survival (EFS) was 70%. The presence of B symptoms, high IPI, failure to attain CR, poor PS, and nonrituximab-based chemotherapy were significantly associated with lower EFS. Conclusions: This is the first study from India, which investigated the impact of chemotherapy with or without rituximab in context of cell of origin. Adding rituximab to CHOP showed better response rate and EFS irrespective of cell of origin.

Independent Predictive Value of PET-CT Pre Transplant in Relapsed and Refractory Patients with CD20 Diffuse Large B-Cell Lymphoma (DLBCL) Included in the CORAL Study.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 881-881 ◽  
Author(s):  
Marek Trneny ◽  
Andre Bosly ◽  
Krimo Bouabdallah ◽  
David Ma ◽  
Ofer Shpilberg ◽  
...  
Keyword(s):  
B Cell ◽  
Response Rate ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Pet Scan ◽  
Factors Affecting ◽  
Early Relapse ◽  
Large B Cell Lymphoma ◽  
Significant Difference ◽  
Large B Cell

Abstract Abstract 881 Salvage chemotherapy followed by high dose therapy and autologous stem cell transplantation (ASCT) is the standard of treatment for chemosensitive relapses in diffuse large B cell lymphoma. The CORAL trial compared the association rituximab, ifosfamide, etoposide, carboplatinum, R-ICE to rituximab dexamethasone Cytarabine and cisplatinum R-DHAP and factors affecting outcome. Methods: DLBCL CD 20+ in first relapse or pts refractory after first line therapy were randomized between R-DHAP and R-ICE. Response was evaluated according to Cheson Criteria (1999); chemosensitive patients after 3 cycles received BEAM and ASCT, and were randomized between observation and maintenance with rituximab for 1 yr. PET scan was not required at the time of design of the study but recommended, whenever possible. Consequently, the assessment of response with PET scan was also performed in a subset of patients and could be compared to revised Cheson criteria (2007). Results: Intent to treat analysis was made on 394 pts ( 201 R ICE arm, 193 R DHAP arm) and was reported earlier this year (J Clin Oncol 27:15s, 2009 (suppl; abstr 8509). There was no difference between the two treatments arms. Prospectively, 123 pts with PET scans were recorded at the end of induction treatment and were reported by investigators positive or negative. Functional imaging was not used to modify treatment protocol. PET was negative ( FDG non-avid) in 61 pts and positive ( FDG-avid) in 62 pts; 60 and 58 pts completed 3 cycles of R-ICE or R-DHAP; 50 PET-ve and 26 PET +ve pts received BEAM respectively. Median age 54 yrs.; 52 relapses >12 months, 71 refractory/early relapses <12 months; 77 pts had prior exposure to rituximab; secondary IPI 0-1 77 pts, sIPI 2-3 40 pts. The overall response rate was 74%, with 47% complete remission. The number of CR, CRu, PR were 42,11,7 in PET negative pts and 1,4,26 in PET positive pts respectively. There was a highly significant difference (p<0.0001) in response rate per CT for PET negative 98% (CI 91-100%) vs. PET positive 50% (CI 37-63%) patients. Thus using updated criteria with PET, all the patients negative, except one stable, should be now characterized as complete responders. Whereas, only 5 pts PET positive were recorded to be in CR or CRu. No histology was available. For the whole population, three years EFS was 30%. EFS were different in pet negative pts 40% vs. 16% for positive pts ( p<0.0001). The same significant difference was found for PFS 43% vs. 28% respectively. Three years overall survival was 47%, for pts PET-ve 66% vs. pts PET+ve 49% ( p=0.007). For the 26 patients submitted to transplantation with PET positivity there was a significant difference for EFS (p=0.03) when compared to PET negative patients, but no statistical difference in PFS and OS. Factors affecting response rate in multivariate analysis were early relapse/refractory < 12 months and PET+ve following induction. The same factors were found in cox's model for EFS and PFS. Conclusion: This prospective study in relapsing DLBCL shows that PET scan is accurate to predict outcome. PET is an independent predictive factor with early relapse/refractory <12 months. A PET positivity pretransplantation is associated with a poor outcome and argues for new therapeutic approaches in this population. Disclosures: No relevant conflicts of interest to declare.

Both FOXP1 and p65 expression are adverse risk factors in diffuse large B-cell lymphoma: A retrospective study in China

2013 ◽  
Vol 115 (2) ◽  
pp. 137-143 ◽  
Author(s):  
Cheng-Ru Hu ◽  
Jing-Hua Wang ◽  
Rui Wang ◽  
Qian Sun ◽  
Long-Bang Chen
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
B Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Large B Cell Lymphoma ◽  
Large B Cell

scholarly journals Bone Marrow Molecular Markers Associated with Relapsed/Refractory Activated B-Cell-Like Diffuse Large B-Cell Lymphoma

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Di Wang ◽  
Peng Liu ◽  
Yue Zhang ◽  
Hui-Ying Liu ◽  
Di Shen ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Molecular Markers ◽  
B Cell ◽  
Bone Marrow Aspirate ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Significant Finding ◽  
Large B Cell Lymphoma ◽  
Significant Difference ◽  
Large B Cell

Activated B-cell-like diffuse large B-cell lymphoma (ABC-DLBCL) is a common subtype of non-Hodgkin’s lymphoma and is very likely to infiltrate the bone marrow. Over 30% of patients are converted to relapsed/refractory DLBCL after first-line rituximab combined with cyclophosphamide, doxorubicin, vincristine, and prednisone therapy, with a poor prognosis. Our aim was to identify molecular markers that might be utilized to predict relapsed/refractory ABC-DLBCL patients. Hence, we collected bone marrow aspirate smears from 202 patients with ABC-DLBCL and detected expression of bone marrow molecular marker proteins by immunocytochemistry. Signal transducer and activator of transcription (Stat)3, nuclear factor (NF)-κB p65, Syk, Bruton’s tyrosine kinase (BTK), and Bcl2 proteins were strongly expressed in bone marrow aspirate smears of ABC-DLBCL patients. The same smear could present positive expression of multiple proteins simultaneously. Positive combinations of protein expression were associated with resistance. The most significant finding was that the Stat3+NF-κB+ group developed resistance, which was significantly higher than that of the Stat3-NF-κB-group (80 vs. 14%). There was a significant difference in two-year relapse-free survival between protein-positive and protein-negative combinations of Stat3-NF-κB (P = 0.005), Bcl2-Stat3 (P = 0.009), Bcl2-Pax5 (P = 0.003), and BTK-Syk (P < 0.001). Thus, we detected key molecules in multiple signaling pathways in bone marrow aspirate smears. At the same time, the results provide further clinical evidence of ABC-DLBCL drug-resistant molecules and provide a theoretical basis for rational second-line treatment after drug resistance.

scholarly journals A Multicenter Retrospective Study of 58 Patients With Primary Thyroid Diffuse Large B Cell Lymphoma

2020 ◽  
Vol 11 ◽  
Author(s):  
Jianing Yi ◽  
Pingyong Yi ◽  
Wei Wang ◽  
Huan Wang ◽  
Xinyu Wang ◽  
...  
Keyword(s):  
Retrospective Study ◽  
B Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Large B Cell Lymphoma ◽  
Large B Cell

Outcome of Diffuse Large B-Cell Lymphoma with First-line Chemotherapy

2021 ◽  
Vol 5 (01) ◽  
pp. 03-09
Author(s):  
Zulfia Zinat Chowdhury ◽  
Tamanna Bahar ◽  
Shaila Rahman ◽  
Salina Haque ◽  
A K M Mynul Islam ◽  
...  
Keyword(s):  
B Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
First Line ◽  
Non Hodgkin Lymphoma ◽  
Large B Cell Lymphoma ◽  
Retrospective Data Analysis ◽  
Significant Difference ◽  
Line Chemotherapy ◽  
Large B Cell

Background: Diffuse Large B-Cell Lymphoma (DLBCL), most common Non-Hodgkin Lymphoma (NHL) variety, is an aggressive, fast-growing form comprising up to 40% of all cases globally. Objective: To observe the treatment outcome of different subtypes of Diffuse Large B-Cell Lymphoma (DLBCL) after first-line chemotherapy and also the association with IHC, presenting age, sex, and IPI score with outcome. Methodology: This is a retrospective data analysis included all DLBCL patients registered in the department of Haematology of National Institute of Cancer Research and Hospital (NICRH) between July 2016 to June 2019. Results: Total 188 cases were included in this study and mean age was 48 years with a Standard deviation of 15 years with Male (69.1%) predominance. We divide the cases into three different entities of DLBCL [Germinal Centre B-cell like (GCB), Non-GCB and others (NOS) among them Non-GCB variety was the prevalent (47.3%) one. After first line   chemotherapy 52.1% complete remission with 7% death was observed in overall outcome. There was no significant difference in outcome among different types of DLBCL after chemotherapy based on Han’s algorithm. Rituximab with CHOP has significantly better outcome than CHOP alone arm (p: 0.021). Conclusion: This limited database study of NICRH will help to ascertain the outcome of DLBCL after first-line chemotherapy in Bangladesh.

scholarly journals Clinical efficacy and molecular biomarkers in a phase II study of tucidinostat plus R-CHOP in elderly patients with newly diagnosed diffuse large B-cell lymphoma

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Mu-Chen Zhang ◽  
Ying Fang ◽  
Li Wang ◽  
Shu Cheng ◽  
Di Fu ◽  
...  
Keyword(s):  
Elderly Patients ◽  
B Cell ◽  
Response Rate ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Molecular Biomarkers ◽  
Newly Diagnosed ◽  
Large B Cell Lymphoma ◽  
Grade 3 ◽  
Large B Cell

Abstract Background Elderly patients with diffuse large B-cell lymphoma (DLBCL) present with poor clinical outcome and intolerance to intensive chemotherapy. Histone deacetylase inhibitors (HDACIs) show anti-lymphoma activities and can be applied to treat DLBCL. This study aimed to evaluate efficacy and safety of oral HDACI tucidinostat (formerly known as chidamide) plus R-CHOP (CR-CHOP) in elderly patients with newly diagnosed DLBCL (International Prognostic Index ≥ 2). Results Among 49 patients, the complete response rate was 86%, with overall response rate achieving 94%. The 2-year progression survival (PFS) and overall survival (OS) rates were 68% (95% CI 52–79) and 83% (95% CI 68–91). Comparing with historical control (NCT01852435), the 2-year PFS and OS rates of double-expressor lymphoma phenotype (DEL) were improved, and negative prognostic effect of histone acetyltransferases CREBBP/EP300 mutations was also mitigated by CR-CHOP. Grade 3–4 neutropenia was reported in 171, grade 3–4 thrombocytopenia in 27, and grade 3 anemia in 11 of 283 cycles. No grade 4 non-hematological adverse event was reported. Conclusion CR-CHOP is effective and safe in elderly patients with newly diagnosed DLBCL. Relevance of DEL phenotype and molecular biomarkers on CR-CHOP response warrants further investigation in DLBCL. Trial registration ClinicalTrial.gov, NCT02753647. Registered on April 28, 2016.

Effectiveness and Safety of Pixantrone for the Treatment of Relapsed or Refractory Diffuse Large B-Cell Lymphoma in Every-Day Clinical Practice: The Italian Cohort of the PIXA Registry

2020 ◽  
pp. 1-5
Author(s):  
Pier Luigi Zinzani ◽  
Marco Bregni ◽  
Mario Spione ◽  
Manfred Mitterer ◽  
Gerardo Musuraca ◽  
...  
Keyword(s):  
Clinical Practice ◽  
B Cell ◽  
Response Rate ◽  
Cell Lymphoma ◽  
Real Life ◽  
Drug Efficacy ◽  
B Cell Lymphoma ◽  
Molecular Profile ◽  
Large B Cell Lymphoma ◽  
Large B Cell

<b><i>Introduction:</i></b> Treatment of relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL) represents a challenge for clinicians due to the lack of therapeutic options. DLBCL is not a rare disease in Italy. Pixantrone is an aza-anthracenedione, which, when compared to anthracyclines and anthracenediones, has a significantly reduced cardiotoxicity while maintaining good anti-tumor activity. However, the evidence on the use of pixantrone in the context of daily clinical practice is scarce. <b><i>Methods:</i></b> We focused on the Italian patient subset of a larger European retrospective study (the PIXA Registry) to assess the efficacy and safety of pixantrone in a real-life DLBCL population. The molecular profile of the disease and its impact on drug efficacy were also assessed. <b><i>Results:</i></b> Fifteen heavily pretreated DLBCL patients (13 males and 2 females) underwent treatment with pixantrone for a median of 2 cycles (range 1–6). Eight patients were bcl2 positive, 7 bcl6 positive, and 4 myc positive; 4 patients were diagnosed as double-hit, and 2 as triple-hit DLBCL. The overall response rate was 26.7% with a best response rate of 46.7%. Three patients had grade IV adverse events, which caused drug discontinuation. Four patients had 5 cases of grade III toxicities (1 thrombocytopenia, 1 stomatitis, and 3 neutropenia). One mild cardiac toxicity (sinus tachycardia for which no action was required) was possibly related to the study drug. <b><i>Conclusion:</i></b> Our data documented drug efficacy that is satisfactory for this high-risk subset of patients with an acceptable toxicity profile. Results indicate that pixantrone could be a significant treatment option in patients with R/R aggressive DLBCL treated in everyday clinical practice.

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