title: Outcome of patients with primary refractory diffuse large B cell lymphoma after R-CHOP treatment.
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.
authors.affiliation: Medical Oncology, Oncology/Haematology, Kantonsspital St. Gallen, 9007, St. Gallen, Switzerland. Felicitas.Hitz@bluewin.ch.|British Columbia Cancer Agency Centre for Lymphoid Cancer, Vancouver, Canada. Felicitas.Hitz@bluewin.ch.|Istituto Oncologico della Svizzera Italiana, Bellinzona, Switzerland. Felicitas.Hitz@bluewin.ch.
authors.forename: Felicitas
authors.initials: F
authors.lastname: Hitz
authors.affiliation: British Columbia Cancer Agency Centre for Lymphoid Cancer, Vancouver, Canada.
authors.forename: J M
authors.initials: JM
authors.lastname: Connors
authors.affiliation: British Columbia Cancer Agency Centre for Lymphoid Cancer, Vancouver, Canada.|Division of Pathology, British Columbia Cancer Agency and the University of British Columbia, Vancouver, Canada.
authors.forename: R D
authors.initials: RD
authors.lastname: Gascoyne
authors.affiliation: British Columbia Cancer Agency Centre for Lymphoid Cancer, Vancouver, Canada.
authors.forename: P
authors.initials: P
authors.lastname: Hoskins
authors.affiliation: British Columbia Cancer Agency Centre for Lymphoid Cancer, Vancouver, Canada.|Istituto Oncologico della Svizzera Italiana, Bellinzona, Switzerland.
authors.forename: A
authors.initials: A
authors.lastname: Moccia
authors.affiliation: British Columbia Cancer Agency Centre for Lymphoid Cancer, Vancouver, Canada.
authors.forename: K J
authors.initials: KJ
authors.lastname: Savage
authors.affiliation: British Columbia Cancer Agency Centre for Lymphoid Cancer, Vancouver, Canada.
authors.forename: L H
authors.initials: LH
authors.lastname: Sehn
authors.affiliation: British Columbia Cancer Agency Centre for Lymphoid Cancer, Vancouver, Canada.
authors.forename: T
authors.initials: T
authors.lastname: Shenkier
authors.affiliation: British Columbia Cancer Agency Centre for Lymphoid Cancer, Vancouver, Canada.
authors.forename: D
authors.initials: D
authors.lastname: Villa
authors.affiliation: British Columbia Cancer Agency Centre for Lymphoid Cancer, Vancouver, Canada.
authors.forename: R
authors.initials: R
authors.lastname: Klasa
mesh_terms: D000328:Adult; D000368:Aged; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001955:British Columbia / Q000453:epidemiology; D003520:Cyclophosphamide / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D019008:Drug Resistance, Neoplasm; D005260:Female; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis* / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use; D011379:Prognosis; D012042:Registries; D000069283:Rituximab; D016019:Survival Analysis; D017211:Treatment Failure; D014750:Vincristine / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; C571759:R-CHOP protocol; D000069283:Rituximab; D014750:Vincristine; D004317:Doxorubicin; D003520:Cyclophosphamide; D011241:Prednisone
keywords: Comorbidity; Diffuse large B cell lymphoma; Primary refractory; R-CHOP