Abstract
Incidence of Relapsed/Refractory Diffuse Large B-Cell Lymphoma (DLBCL) Including CNS Relapse in a Population-Based Cohort of 4205 Patients in Sweden
Highlights
Introduction Diffuse largeB-cell lymphoma (DLBCL) is the most common subtype of lymphoma and has an aggressive clinical course[1]
In this large nationwide population-based study, we demonstrate that the proportion of diffuse large B-cell lymphoma (DLBCL) patients overall that experience progression or relapse is only 18.9% at 2 years and 23.1% at 5 years, considerably lower than generally stated[17,18,19,20]
The incidence of central nervous system (CNS) relapse was low; 3.0% in the whole cohort and 8.0% among high-risk patients (CNS International prognostic index (IPI) 4–6). We believe these real-world benchmark figures are important for patients as well as physicians and policy makers to help estimate patient numbers eligible for new treatments in the era of targeted therapies for relapsed/refractory disease
Summary
B-cell lymphoma (DLBCL) is the most common subtype of lymphoma and has an aggressive clinical course[1]. Known clinical risk factors for relapse include advanced stage, high age, elevated serum lactate dehydrogenase (LDH), poor performance status and involvement of more than one extranodal site, as summarized in the widely used International prognostic index (IPI) score[9]. To estimate the risk of central nervous system (CNS) relapse, the CNS-IPI was developed based on IPI with the addition of kidney and/or adrenal gland involvement[10]. 20 years ago, gene-expression profiling techniques were used to identify biological subtypes of DLBCL by cell of origin, the germinal center B-cell (GCB) and activated
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