Diffuse large B-cell lymphoma with primary treatment failure: Ultra-high risk features and benchmarking for experimental therapies

Luciano J. Costa, Kami Maddocks, Narendranath Epperla, Nishitha M. Reddy, Reem Karmali, Elvira Umyarova, Veronika Bachanova, Cristiana Costa, Martha J. Glenn, Julio C. Chavez, Oscar Calzada, Frederick Lansigan, Hossain Nasheed, Stefan K. Barta, Zheng Zhou, Michael Jaglal, Saurabh Chhabra, Francisco Hernandez-Ilizaliturri, Ana C. Xavier, Amitkumar MehtaDeniz Peker, Andreas Forero-Torres, Zeina Al-Mansour, Andrew M. Evens, Jonathon B. Cohen, Christopher R. Flowers, Timothy S. Fenske, Mehdi Hamadani

Research output: Contribution to journalArticle

24 Scopus citations

Abstract

The outcomes of patients with DLBCL and primary treatment failure (PTF) in the rituximab era are unclear. We analyzed 331 patients with PTF, defined as primary progression while on upfront chemoimmunotherapy (PP), residual disease at the end of upfront therapy (RD) or relapse < 6 months from end of therapy (early relapse; ER). Median age was 58 years and response to salvage was 41.7%. Two-year OS was 18.5% in PP, 30.6% in RD and 45.5% in ER. The presence of PP, intermediate-high/high NCCN-IPI at time of PTF or MYC translocation predicted 2-year OS of 13.6% constituting ultra-high risk (UHR) features. Among the 132 patients who underwent autologous hematopoietic cell transplantation, 2-year OS was 74.3%, 59.6% and 10.7% for patients with 0,1 and 2–3 UHR features respectively. Patients with PTF and UHR features should be prioritized for clinical trials with newer agents and innovative cellular therapy.

Original languageEnglish (US)
Pages (from-to)161-170
Number of pages10
JournalAmerican Journal of Hematology
Volume92
Issue number2
DOIs
StatePublished - Feb 1 2017

ASJC Scopus subject areas

  • Hematology

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    Costa, L. J., Maddocks, K., Epperla, N., Reddy, N. M., Karmali, R., Umyarova, E., Bachanova, V., Costa, C., Glenn, M. J., Chavez, J. C., Calzada, O., Lansigan, F., Nasheed, H., Barta, S. K., Zhou, Z., Jaglal, M., Chhabra, S., Hernandez-Ilizaliturri, F., Xavier, A. C., ... Hamadani, M. (2017). Diffuse large B-cell lymphoma with primary treatment failure: Ultra-high risk features and benchmarking for experimental therapies. American Journal of Hematology, 92(2), 161-170. https://doi.org/10.1002/ajh.24615