Younger Patients With Relapsed or Refractory DLBCL Have Poor Survival Rates

Adolescents and young adults (AYAs) diagnosed with relapsed or refractory diffuse large B-cell lymphoma (DLBCL) continue to have poor clinical outcomes, despite improvements in therapy options in recent years, according to research published in the Journal of Adolescent and Young Adult Oncology. AYAs without relapsed or refractory disease who received conventional therapy, however, had similar outcomes to adult patients.

Clinical trials published in recent years have shown disparate survival findings among both pediatric and adolescent patients, which hinders progress towards standardization of care for DLBCL. For this retrospective analysis of real-world data, researchers evaluated clinical outcomes among AYAs diagnosed with DLBCL.

Overall, data from 90 patients were included. In this cohort, the median age at diagnosis was 33 years, 91% of patients were aged between 25 and 39 years, 57% of patients were male, 43% of patients had a performance status of less than 90, and 32% of patients had relapsed or refractory disease.

The median follow-up was 83 months. Analysis showed that the 5-year overall survival (OS) rate was 79% in the overall cohort; the 5-year progression-free survival rate was 67%.

Patients who received R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone; 77% received this in the first line) had a 5-year OS rate of 77% and a 5-year progression-free survival rate of 66%.

Among patients with relapsed or refractory disease, 83% received second-line treatment, while 14% received consolidation therapy and transplantation. In the relapsed/refractory DLBCL subgroup, the 3-year OS rate was 36%.

“Patients who experienced [relapsed/refractory] disease had a dismal prognosis, with a high mortality rate within 2 years of [relapsed/refractory] diagnosis, underscoring a significant unmet need in this setting,” the authors wrote in their report. “Greater efforts should be made to identify high-risk patients and increase access to novel treatments to improve outcomes in [relapsed/refractory] patients.”

Reference

Castro-Uriol D, Rios L, Enriquez-Vera D, et al. Real-world outcomes of adolescents and young adults with diffuse large B-cell lymphoma: a multicenter retrospective cohort study. J Adolesc Young Adult Oncol. Published online October 16, 2023. doi:10.1089/jayao.2023.0095

This article originally appeared on Hematology Advisor