Treatment intensity and survival in patients with relapsed or refractory diffuse large B-cell lymphoma in Denmark: A real-life populationbased study
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Treatment intensity and survival in patients with relapsed or refractory diffuse large B-cell lymphoma in Denmark : A real-life populationbased study. / Arboe, Bente; Olsen, Maja Halgren; Gørløv, Jette Sønderskov; Duun-Henriksen, Anne Katrine; Dalton, Susanne Oksbjerg; Johansen, Christoffer; De Nully Brown, Peter.
I: Clinical Epidemiology, Bind 11, 2019, s. 207-216.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Treatment intensity and survival in patients with relapsed or refractory diffuse large B-cell lymphoma in Denmark
T2 - A real-life populationbased study
AU - Arboe, Bente
AU - Olsen, Maja Halgren
AU - Gørløv, Jette Sønderskov
AU - Duun-Henriksen, Anne Katrine
AU - Dalton, Susanne Oksbjerg
AU - Johansen, Christoffer
AU - De Nully Brown, Peter
PY - 2019
Y1 - 2019
N2 - Purpose: High-dose chemotherapy with autologous stem cell transplantation (ASCT) is considered to be the only curative treatment option for patients with refractory or relapsed diffuse large B-cell lymphoma (DLBCL). Due to toxicity, not all patients are eligible for this treatment leading to different treatment intensities. Here, we aim to analyze the impact of treatment intensity on survival in patients previously treated with rituximab and chemotherapy, and, furthermore, to analyze the association between socioeconomic position and treatment intensity, defined as palliation, non-salvage, and salvage regimens. Materials and methods: We identified patients with refractory or relapsed DLBCL diagnosed in 2000-2015 in the Danish National Lymphoma Registry (n=1,228). We analyzed the impact of treatment intensity on survival in patients previously treated with rituximab (n=277) using a Cox proportional hazards model. Multinomial regression analyses were performed to identify associations between socioeconomic factors and treatment intensity for the entire cohort. Results: In the rituximab era, the 5-year overall survival (OS) was 31% for patients receiving salvage regimens (n=194), and 17% for patients receiving non-salvage regimens (n=83). In the adjusted analysis, HR was 1.88, 95% CI: 0.9-3.9 for patients receiving salvage regimens. Patients living alone were significantly less likely to receive salvage regimens, as were patients with two or more comorbidities. Conclusion: We observed a better OS in patients treated with salvage regimens compared with non-salvage regimens; however, the adjusted analysis contradicts this. Furthermore, our results indicate that there is a chance of remission for patients not eligible for ASCT.
AB - Purpose: High-dose chemotherapy with autologous stem cell transplantation (ASCT) is considered to be the only curative treatment option for patients with refractory or relapsed diffuse large B-cell lymphoma (DLBCL). Due to toxicity, not all patients are eligible for this treatment leading to different treatment intensities. Here, we aim to analyze the impact of treatment intensity on survival in patients previously treated with rituximab and chemotherapy, and, furthermore, to analyze the association between socioeconomic position and treatment intensity, defined as palliation, non-salvage, and salvage regimens. Materials and methods: We identified patients with refractory or relapsed DLBCL diagnosed in 2000-2015 in the Danish National Lymphoma Registry (n=1,228). We analyzed the impact of treatment intensity on survival in patients previously treated with rituximab (n=277) using a Cox proportional hazards model. Multinomial regression analyses were performed to identify associations between socioeconomic factors and treatment intensity for the entire cohort. Results: In the rituximab era, the 5-year overall survival (OS) was 31% for patients receiving salvage regimens (n=194), and 17% for patients receiving non-salvage regimens (n=83). In the adjusted analysis, HR was 1.88, 95% CI: 0.9-3.9 for patients receiving salvage regimens. Patients living alone were significantly less likely to receive salvage regimens, as were patients with two or more comorbidities. Conclusion: We observed a better OS in patients treated with salvage regimens compared with non-salvage regimens; however, the adjusted analysis contradicts this. Furthermore, our results indicate that there is a chance of remission for patients not eligible for ASCT.
KW - Chemotherapy
KW - Education
KW - Epidemiology
KW - Income
KW - Non-Hodgkin lymphoma
KW - Socioeconomic status
KW - Stem cell transplantation
U2 - 10.2147/CLEP.S178003
DO - 10.2147/CLEP.S178003
M3 - Journal article
C2 - 30881137
AN - SCOPUS:85067545591
VL - 11
SP - 207
EP - 216
JO - Clinical Epidemiology
JF - Clinical Epidemiology
SN - 1179-1349
ER -
ID: 235918357