Tumor necrosis could reflect advanced disease status in patients with diffuse large B cell lymphoma treated with R-CHOP therapy

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• 作者：Moo-Kon Song ; Joo-Seop Chung ; Dong-Yeop Shin ; Sung-Nam Lim…
• 关键词：Tumor necrosis ; Diffuse large B cell lymphoma ; Ann Arbor stage ; Survival
• 刊名：Annals of Hematology
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：96
• 期：1
• 页码：17-23
• 全文大小：
• 刊物类别：Medicine
• 刊物主题：Hematology; Oncology;
• 出版者：Springer Berlin Heidelberg
• ISSN：1432-0584
• 卷排序：96

文摘

Tumor necrosis (TN) can lower responsiveness to chemotherapy and confer basic resistance to anti-cancer therapy. We investigated the association of TN with poor clinical features and outcome in diffuse large B cell lymphoma (DLBCL). We examined the presence or absence of TN in 476 DLBCL patients of who received rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) therapy. Eighty-nine (18.7 %) patients had TN at diagnosis. Patients with TN had a progression-free survival (PFS) and overall survival (OS) of 39.3 and 46.7 %, whereas patients without TN had a PFS and OS of 73.4 and 82.6 %. Adverse clinical factors of poor Eastern Cooperative Oncology Group performance status ≥ grade 2 (p = 0.005), elevated lactate dehydrogenase ratio >1 (p < 0.001), advanced Ann Arbor stage (p = 0.002), and bulky disease (p = 0.026) were more prevalent in the TN group than the non-TN group. Cox regression model analysis revealed TN as an independent prognostic factor for PFS and OS in DLBCL (PFS, hazard ratio [HR] = 1.967, 95 % confidence interval [CI] = 1.399–2.765, p < 0.001; OS, HR = 2.445, 95 % CI = 1.689–3.640, p < 0.001). The results indicate that TN could reflect adverse clinical features and worse prognosis in DLBCL patients receiving R-CHOP therapy.