%0 Journal Article
%T Detailed Analysis of Diffuse Large B Cell Lymphoma Patients: A Single-Center, Retrospective Study
%A Murat Ozbalak
%A M. Cem Ar
%A Nukhet Tuzuner
%A Ayse Salihoglu
%A A. Emre Eskazan
%A Seniz Ongoren Aydin
%A Zafer Baslar
%A Teoman Soysal
%A Yildiz Aydin
%A Anil Barak Dolgun
%A Onder Ergonul
%A Burhan Ferhanoglu
%J ISRN Hematology
%D 2013
%R 10.1155/2013/908191
%X The aim of this single-center, retrospective study was to investigate the impact of rituximab, reconsider the validity of International Prognostic Index (IPI), and evaluate the prognostic role of the cell of origin (CoO) in a relatively young cohort. Three hundred twelve diffuse large B cell lymphoma patients (median age: 52) were included. Rituximab significantly improved the 3- and 5-year progression free survival (PFS) (70% versus 65% and 41% versus 36%, resp.; ) but led only to a slight, insignificant increase in 3- and 5-year overall survival (OS) (71% versus 77.3% and %67 versus 74.5%, resp.; ). In the young, low risk patient subgroup (aaIPI = 0&1; ), rituximab improved 3- and 5-year PFS and OS rates ( and , resp.). The efficacy of rituximab in young high risk patients was comparable to the literature. CoO data were available in 190 patients. The OS at 3 years was 79% for GC and 64% for non-GC subgroups ( ). To the best of our knowledge, this is the first study which investigated the impact of R-CHOP in the context of CoO and IPI in a relatively young cohort. CoO was not an independent risk factor for prognosis in the multivariate analysis although patients with GC showed a significant survival advantage in the univariate analysis. CoO was also found to be a significant determinant of response in refractory/relapsed patients. Our results confirm the efficacy of rituximab in low and high risk, young patients outside of a randomized clinical trial setting. 1. Introduction Diffuse large B cell lymphoma (DLBCL), being the most common morphological type, constitutes about 40% of newly diagnosed non-Hodgkin¡¯s lymphoma (NHL) cases. It is a heterogeneous disease with variable clinical course and prognostic outcome. Addition of the immunotherapeutic agent rituximab to chemotherapy improved the response rates in NHL [1]. However, despite major progress in the treatment, responses are not durable and the outcome is fatal in almost half of the patients with DLBCL. Therefore, great interest has been shown to develop prognostic scoring systems that would predict the outcome and identify patients with worst prognosis who would benefit from treatment strategies other than the standard regimens. Until recently, International Prognostic Index (IPI) [2] was almost the only widely used prognostic indicator in DLBCL. However, increasing evidence suggest that IPI fails to predict the prognosis in a considerable portion of patients with DLBCL. Consequently, there is a need for an improved and/or refined prognostic index which would predict the outcome more precisely. In
%U http://www.hindawi.com/journals/isrn.hematology/2013/908191/