Clinical characteristics and outcomes of patients with diffuse large B cell lymphoma treated with R-CHOP-like or CHOP-like regimens: an 8-year experience from a single center.

Abstract

The CHOP regimen comprising cyclophosphamide, doxorubicin, vincristine, and prednisone is a basic chemotherapeutic regimen for diffuse large B cell lymphoma (DLBCL). Addition of rituximab (R) to chemotherapy has led to better efficacy than other regimens in clinical trials. However, data of clinical characteristics and outcomes of patients with DLBCL are scarce. Therefore, this study reports the clinical characteristics, treatment, and outcomes of patients with DLBCL in our hospital. We conducted a retrospective analysis of newly diagnosed DLBCL patients treated with CHOP-like or R-CHOP-like regimens at our hospital between 2011 and 2018. We analyzed the data on demography, clinical characteristics, treatment, treatment response, and survival time. Both univariate and multivariate analyses were applied. In total, 570 newly diagnosed DLBCL patients were included, of which 133 were treated with CHOP-like regimens and 437 with R-CHOP-like regimens. The overall response rate was 83.3%. Germinal center B-cell-like (GCB) subtype, R-CHOP-like treatment, Ann Arbor stage I-II, not more than 1 extranodal disease site, Eastern Cooperative Oncology Group (ECOG) score ≤1, normal serum lactate dehydrogenase (LDH) level, normal serum β2 microglobulin (β2-MG) level, absence of B symptoms, and lower International Prognostic Index (IPI) or National Comprehensive Cancer Network-International Prognostic Index (NCCN-IPI) scores were associated with longer overall survival (OS) and progressionfree survival (PFS), and were favorable prognostic factors for OS and PFS. Only GCB subtype, R-CHOPlike treatment, absence of B symptoms, and lower IPI or NCCN-IPI scores were independent favorable prognostic factors for OS and/or PFS. Neither IPI nor NCCN-IPI could accurately and precisely predict the prognosis of high-risk DLBCL patients. This analysis of newly diagnosed DLBCL patients indicates that patients treated with R-CHOP-like regimens or with GCB subtype exhibited better outcomes. Further, IPI and NCCN-IPI have limited prognostic values in high-risk DLBCL patients.