Clinical Characteristics and Outcomes of Patients with Diffuse Large B-Cell Lymphoma Treated Using R-CHOP

Abstract

Diffuse large B-cell lymphoma (DLBCL) is an aggressive non-Hodgkin lymphoma with a fairly high prevalence in Indonesia and a relatively poor prognosis. Addition of rituximab (R) to chemotherapy has led to better efficacy than other regimens in clinical trials. However, data on clinical characteristics and outcomes of patients with DLBCL are scarce. This retrospective cohort study analyzed patients' medical records of DLBCL patients from 2014 to 2021 at dr. Cipto Mangunkusumo National Hospital. Patients’ demographics, clinical characteristics, treatment responses, and 24-month event-free survival (EFS) were assessed using univariate analyses and receiver operating characteristic curves. A total of 100 patients were included, comprising 46% male and 54% female, with the majority (83%) aged <60 years. Complete response (CR) was observed in 44.2% of males and 55.8% of females, while non-complete response (non-CR) occurred in 60% and 40%, respectively. Among patients under 60 years old, CR and non-CR were 92% and 88.4%, respectively. Low and high international prognostic index (IPI) scores accounted for 58.8% and 41.2%, with corresponding CR therapy responses of 27% and 10%, and non-CR therapy responses of 52.9% and 47.1%. The majority of patients were of the non-germinal center B-cell-like (GCB) subtype (81%) compared to GCB (15%), with CR therapy responses of 84.8% and 15.2%, and non-CR therapy responses of 75% and 25%, respectively. The 24-month EFS rate was 68%. The clinical characteristics observed in this study differ from those reported in Western populations, where younger age, female gender, low IPI scores, and non-GCB subtypes were more prevalent. These findings highlight the need for further investigation to understand regional differences in DLBCL better.