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Outcome of patients with primary refractory diffuse large B cell lymphoma after R-CHOP treatment

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Abstract

Primary refractory diffuse large B cell lymphoma (DLBCL) following R-CHOP chemotherapy is a major concern. We identified 1126 patients with DLBCL treated with R-CHOP from 2000 to 2009, of whom 166 (15 %) had primary refractory disease. Of the 75/166 (45 %) who were age <70 years and had been planned for stage-directed curative therapy, 43 (57 %) were primary nonresponders and 32 (43 %) relapsed within 3 months of completing R-CHOP. Thirty of 75 (40 %) patients had serious comorbidity and organ dysfunction precluding intensive treatment and had palliative treatment only. Twelve of 45 (27 %) patients responded to second-line treatment and underwent ASCT. The median overall survival for the 75 patients was 10 months with only seven patients alive without evidence of disease at follow-up ranging from 14 to 106 months. Primary refractory DLBCL after R-CHOP has a very poor outcome with only anecdotal survivors independent of the intended treatment approach.

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Acknowledgments

The authors thank the patients of British Columbia and their clinicians for referral to BCCA for treatment and inclusion of their outcomes in this report; Suman Singh and Jane Donaldson for help with data collection. A preliminary analysis of the results reported in this paper were presented at the meeting of the American Society of Hematology in Orlando in December 2010.

Conflict of interest

The authors have no conflict of interest to declare.

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Authors and Affiliations

  1. Medical Oncology, Oncology/Haematology, Kantonsspital St. Gallen, 9007, St. Gallen, Switzerland

    Felicitas Hitz

  2. British Columbia Cancer Agency Centre for Lymphoid Cancer, Vancouver, Canada

    Felicitas Hitz, J. M. Connors, R. D. Gascoyne, P. Hoskins, A. Moccia, K. J. Savage, L. H. Sehn, T. Shenkier, D. Villa & R. Klasa

  3. Division of Pathology, British Columbia Cancer Agency and the University of British Columbia, Vancouver, Canada

    R. D. Gascoyne

  4. Istituto Oncologico della Svizzera Italiana, Bellinzona, Switzerland

    Felicitas Hitz & A. Moccia

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  1. Felicitas Hitz
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  2. J. M. Connors
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  3. R. D. Gascoyne
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  4. P. Hoskins
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  6. K. J. Savage
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  7. L. H. Sehn
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  8. T. Shenkier
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  9. D. Villa
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  10. R. Klasa
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Correspondence to Felicitas Hitz.

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Hitz, F., Connors, J.M., Gascoyne, R.D. et al. Outcome of patients with primary refractory diffuse large B cell lymphoma after R-CHOP treatment. Ann Hematol 94, 1839–1843 (2015). https://doi.org/10.1007/s00277-015-2467-z

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  • DOI: https://doi.org/10.1007/s00277-015-2467-z

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