title: Impact of time from diagnosis to initiation of curative chemotherapy on survival of patients with diffuse large B-cell lymphoma.
abstract: Although it is generally regarded appropriate to start chemotherapy promptly after a diagnosis of diffuse large B-cell lymphoma (DLBCL), the optimal time from diagnosis to treatment (TDT) is unknown. A total of 689 patients diagnosed with DLBCL and treated with ≥ 1 cycle of CHOP-R with curative intent during 2003-2008 in British Columbia were identified: 347 (50%) TDT ≤ 4 weeks, 277 (40%) TDT 5-8 weeks, 65 (10%) TDT > 8 weeks. For the respective TDT groups, 5-year OS estimates were 61%, 74%, 63% (p = 0.006); 5-year PFS 57%, 70%, 61% (p = 0.006); and 5-year DSS 64%, 80%, 77% (p <0.001). In multivariate analysis, TDT >8 weeks was associated with worse OS (HR 1.20 (95% CI 1.03, 1.41), p = 0.020), PFS (HR 1.33 (95% CI 1.15, 1.54), p < 0.001), and DSS (HR 1.40 (95% CI 1.10, 1.78), p = 0.006). Clinicians should endeavor to initiate curative chemotherapy as soon as possible after a diagnosis of DLBCL is established.
authors.affiliation: a Department of Medicine , University of British Columbia , Vancouver , BC , Canada.
authors.forename: Kevin
authors.initials: K
authors.lastname: Hay
authors.affiliation: b Faculty of Medicine, University of British Columbia , Vancouver , BC , Canada.
authors.forename: Benny
authors.initials: B
authors.lastname: Lee
authors.affiliation: c Cancer Surveillance & Outcomes, British Columbia Cancer Agency , Vancouver , BC , Canada.
authors.forename: Ozge
authors.initials: O
authors.lastname: Goktepe
authors.affiliation: d Division of Medical Oncology, University of British Columbia, and the British Columbia Cancer Agency Centre for Lymphoid Cancer , Vancouver , BC , Canada.
authors.forename: Joseph M
authors.initials: JM
authors.lastname: Connors
authors.affiliation: d Division of Medical Oncology, University of British Columbia, and the British Columbia Cancer Agency Centre for Lymphoid Cancer , Vancouver , BC , Canada.
authors.forename: Laurie H
authors.initials: LH
authors.lastname: Sehn
authors.affiliation: d Division of Medical Oncology, University of British Columbia, and the British Columbia Cancer Agency Centre for Lymphoid Cancer , Vancouver , BC , Canada.
authors.forename: Kerry J
authors.initials: KJ
authors.lastname: Savage
authors.affiliation: d Division of Medical Oncology, University of British Columbia, and the British Columbia Cancer Agency Centre for Lymphoid Cancer , Vancouver , BC , Canada.
authors.forename: Richard
authors.initials: R
authors.lastname: Klasa
authors.affiliation: d Division of Medical Oncology, University of British Columbia, and the British Columbia Cancer Agency Centre for Lymphoid Cancer , Vancouver , BC , Canada.
authors.forename: Tamara
authors.initials: T
authors.lastname: Shenkier
authors.affiliation: d Division of Medical Oncology, University of British Columbia, and the British Columbia Cancer Agency Centre for Lymphoid Cancer , Vancouver , BC , Canada.|e Leukemia/Bone Marrow Transplantation Program of BC , Vancouver , BC , Canada.
authors.forename: Alina
authors.initials: A
authors.lastname: Gerrie
authors.affiliation: d Division of Medical Oncology, University of British Columbia, and the British Columbia Cancer Agency Centre for Lymphoid Cancer , Vancouver , BC , Canada.
authors.forename: Diego
authors.initials: D
authors.lastname: Villa
keywords: Antibody-based immunotherapy; chemotherapeutic approaches; lymphoma and Hodgkin disease