Outcomes and factors influencing survival in patients with diffuse large B-cell lymphoma: a population-based analysis
Abstract: Given the rapidly evolving treatment landscape for diffuse large B-cell lymphoma (DLBCL), we performed a contemporary analysis of survival outcomes in patients aged ≥18 years with DLBCL at the population level using linked administrative data sets in Ontario, Canada (ICES). Among 8675 pati...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-08-01
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| Series: | Blood Neoplasia |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2950328025000524 |
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| author | Inna Y. Gong Michael Crump Anca Prica Andrew Calzavara Ning Liu Tiana Kordbacheh Danielle Rodin David Hodgson Lee Mozessohn Matthew C. Cheung John Kuruvilla |
| author_facet | Inna Y. Gong Michael Crump Anca Prica Andrew Calzavara Ning Liu Tiana Kordbacheh Danielle Rodin David Hodgson Lee Mozessohn Matthew C. Cheung John Kuruvilla |
| author_sort | Inna Y. Gong |
| collection | DOAJ |
| description | Abstract: Given the rapidly evolving treatment landscape for diffuse large B-cell lymphoma (DLBCL), we performed a contemporary analysis of survival outcomes in patients aged ≥18 years with DLBCL at the population level using linked administrative data sets in Ontario, Canada (ICES). Among 8675 patients (median age, 67 years; 44% female) treated with frontline rituximab-based therapy, 1675 (19%) were treated with second-line therapy (2L). The 2-year and 5-year overall survival (OS) from 2L were 33% and 26%, respectively. Univariate analysis demonstrated that curative-intent therapy (autologous stem cell transplantation [ASCT]) (58% of patients) was associated with better OS than palliative radiotherapy (hazard ratio [HR], 0.56; P < .0001). Patients aged ≥60 years showed inferior OS than those aged <60 years (age 60-69 years: HR, 1.35; P =.0002; aged 70-79 years: HR, 1.64; P < .0001; age ≥80 years: HR, 2.08; P < .0001). In addition, early relapse was associated with worse outcomes than relapses occurring after 2 years (<3 months: HR, 1.45; P =.0002; 3-6 months: HR, 1.51; P =.0001; 6-12 months: HR, 1.88; P < .0001). Multivariable analysis confirmed these associations while accounting for lactate dehydrogenase, comorbidity burden, frailty, and income. Exploratory analysis indicated that third-line chimeric antigen receptor T-cell (CAR-T) therapy was associated with improved outcomes compared to a historical cohort of patients treated with palliative therapy before 2020 (2-year OS 56% vs 21%). This population-based analysis suggests that curative-intent therapy (ASCT and CAR-T) is associated with improved OS over conventional treatment approaches. The outcomes presented here provide benchmarks for future analyses aimed at assessing the effects of novel treatments in the 2L on outcomes. |
| format | Article |
| id | doaj-art-4b677720f4674d3e9eef36e08c730205 |
| institution | Kabale University |
| issn | 2950-3280 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Blood Neoplasia |
| spelling | doaj-art-4b677720f4674d3e9eef36e08c7302052025-08-20T03:35:44ZengElsevierBlood Neoplasia2950-32802025-08-012310011710.1016/j.bneo.2025.100117Outcomes and factors influencing survival in patients with diffuse large B-cell lymphoma: a population-based analysisInna Y. Gong0Michael Crump1Anca Prica2Andrew Calzavara3Ning Liu4Tiana Kordbacheh5Danielle Rodin6David Hodgson7Lee Mozessohn8Matthew C. Cheung9John Kuruvilla10Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, ON, Canada; Department of Medicine, University of Toronto, Toronto, ON, CanadaDivision of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, ON, Canada; Department of Medicine, University of Toronto, Toronto, ON, CanadaDivision of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, ON, Canada; Department of Medicine, University of Toronto, Toronto, ON, Canada; ICES, Toronto, ON, CanadaDepartment of Medicine, University of Toronto, Toronto, ON, CanadaDepartment of Medicine, University of Toronto, Toronto, ON, CanadaDivision of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, ON, Canada; Department of Medicine, University of Toronto, Toronto, ON, CanadaRadiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON, Canada; Department of Radiation Oncology, University of Toronto, Toronto, ON, CanadaRadiation Medicine Program, Princess Margaret Cancer Centre, Toronto, ON, Canada; Department of Radiation Oncology, University of Toronto, Toronto, ON, CanadaICES, Toronto, ON, Canada; Department of Medical Oncology and Hematology, Sunnybrook Odette Cancer Centre, Toronto, ON, CanadaICES, Toronto, ON, Canada; Department of Medical Oncology and Hematology, Sunnybrook Odette Cancer Centre, Toronto, ON, CanadaDivision of Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, ON, Canada; Department of Medicine, University of Toronto, Toronto, ON, Canada; Correspondence: John Kuruvilla, Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, 6-424, 700 University Ave, Toronto, ON M5G 1Z5, Canada;Abstract: Given the rapidly evolving treatment landscape for diffuse large B-cell lymphoma (DLBCL), we performed a contemporary analysis of survival outcomes in patients aged ≥18 years with DLBCL at the population level using linked administrative data sets in Ontario, Canada (ICES). Among 8675 patients (median age, 67 years; 44% female) treated with frontline rituximab-based therapy, 1675 (19%) were treated with second-line therapy (2L). The 2-year and 5-year overall survival (OS) from 2L were 33% and 26%, respectively. Univariate analysis demonstrated that curative-intent therapy (autologous stem cell transplantation [ASCT]) (58% of patients) was associated with better OS than palliative radiotherapy (hazard ratio [HR], 0.56; P < .0001). Patients aged ≥60 years showed inferior OS than those aged <60 years (age 60-69 years: HR, 1.35; P =.0002; aged 70-79 years: HR, 1.64; P < .0001; age ≥80 years: HR, 2.08; P < .0001). In addition, early relapse was associated with worse outcomes than relapses occurring after 2 years (<3 months: HR, 1.45; P =.0002; 3-6 months: HR, 1.51; P =.0001; 6-12 months: HR, 1.88; P < .0001). Multivariable analysis confirmed these associations while accounting for lactate dehydrogenase, comorbidity burden, frailty, and income. Exploratory analysis indicated that third-line chimeric antigen receptor T-cell (CAR-T) therapy was associated with improved outcomes compared to a historical cohort of patients treated with palliative therapy before 2020 (2-year OS 56% vs 21%). This population-based analysis suggests that curative-intent therapy (ASCT and CAR-T) is associated with improved OS over conventional treatment approaches. The outcomes presented here provide benchmarks for future analyses aimed at assessing the effects of novel treatments in the 2L on outcomes.http://www.sciencedirect.com/science/article/pii/S2950328025000524 |
| spellingShingle | Inna Y. Gong Michael Crump Anca Prica Andrew Calzavara Ning Liu Tiana Kordbacheh Danielle Rodin David Hodgson Lee Mozessohn Matthew C. Cheung John Kuruvilla Outcomes and factors influencing survival in patients with diffuse large B-cell lymphoma: a population-based analysis Blood Neoplasia |
| title | Outcomes and factors influencing survival in patients with diffuse large B-cell lymphoma: a population-based analysis |
| title_full | Outcomes and factors influencing survival in patients with diffuse large B-cell lymphoma: a population-based analysis |
| title_fullStr | Outcomes and factors influencing survival in patients with diffuse large B-cell lymphoma: a population-based analysis |
| title_full_unstemmed | Outcomes and factors influencing survival in patients with diffuse large B-cell lymphoma: a population-based analysis |
| title_short | Outcomes and factors influencing survival in patients with diffuse large B-cell lymphoma: a population-based analysis |
| title_sort | outcomes and factors influencing survival in patients with diffuse large b cell lymphoma a population based analysis |
| url | http://www.sciencedirect.com/science/article/pii/S2950328025000524 |
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