The clinical, paraclinical characteristics and treatment of diffuse large B-cell Lymphoma based on cell of origin
Main Article Content
Abstract
This study aimed to identify the relationship between clinical, paraclinical characteristics, and treatment response with the cell of origin in patients with diffuse large B-cell lymphoma (DLBCL). A cross-sectional descriptive study was conducted on 142 patients diagnosed and treated for DLBCL at the Military Hospital 103 from 2019 to 2024. The GCB subtype accounted for 35.2%, while the non-GCB subtype accounted for 64.8%. The proportion of patients in the GCB group with an ECOG performance status ≥ 2 and an R-IPI score ≥ 3 was significantly lower compared to the non-GCB group (p = 0.012; p = 0.037). B symptoms were more common in the non-GCB group than in the GCB group (p = 0.002). The non-GCB group had higher rates of elevated serum levels of LDH and β2-microglobulin (p = 0.028; p = 0.027). Notably, the complete response rate in the GCB group was 78.0%, which was significantly higher than the 56.5% observed in the non-GCB group (p = 0.036. These findings indicate that a significant difference in prognosis, biological characteristics, and treatment response based on the subtype of DLBCL in patients.
Article Details
Keywords
Diffuse large B-cell lymphoma, Germinal Center B-cell-like, Activated B-cell-like
References
2. Alaggio R, Amador C, Anagnostopoulos I, et al. The 5th edition of the World Health Organization classification of haematolymphoid tumours: lymphoid neoplasms. Leukemia. 2022; 36(7): 1720-1748.
3. Wang Y, Farooq U, Link BK, et al. Late relapses in patients with diffuse large B-cell lymphoma treated with immunochemotherapy. Journal of Clinical Oncology. 2019; 37(21): 1819-1827.
4. Harrysson S, Eloranta S, Ekberg S, et al. Incidence of relapsed/refractory diffuse large B-cell lymphoma (DLBCL) including CNS relapse in a population-based cohort of 4243 patients in Sweden. Blood cancer journal. 2021; 11(1): 9.
5. Frontzek F, Lenz G. Novel insights into the pathogenesis of molecular subtypes of diffuse large B-cell lymphoma and their clinical implications. Expert Rev Clin Pharmacol. Nov 2019; 12(11): 1059-1067.
6. Hans CP, Weisenburger DD, Greiner TC, et al. Confirmation of the molecular classification of diffuse large B-cell lymphoma by immunohistochemistry using a tissue microarray. Blood. Jan 1 2004; 103(1): 275-82.
7. Choi WW, Weisenburger DD, Greiner TC, et al. A new immunostain algorithm classifies diffuse large B-cell lymphoma into molecular subtypes with high accuracy. Clin Cancer Res. Sep 1 2009; 15(17): 5494-502.
8. Mandloi SS, Thumaty DB, Nisha Y, et al. Clinico-Pathologic Profile and Treatment outcomes of patients with diffuse large B cell lymphoma based on cell of origin classification. Indian Journal of Hematology and Blood Transfusion. 2021; 37(2): 226-231.
9. Lu T-X, Miao Y, Wu J-Z, et al. The distinct clinical features and prognosis of the CD10+ MUM1+ and CD10− Bcl6− MUM1− diffuse large B-cell lymphoma. Scientific reports. 2016; 6(1): 20465.
10. Cheson BD. Staging and response assessment in lymphomas: the new Lugano classification. Chinese clinical oncology. 2015; 4(1): 5-5.
11. Thiều Thị Hằng, Phạm Cẩm Phương, Phạm Văn Thái và cộng sự. Đặc điểm hình ảnh 18F-FDG-PET/CT với một số thể mô bệnh học U lympho ác tính không Hodgkin tại Bệnh viện Bạch Mai giai đoạn 2017-2022. Tạp chí Điện quang & Y học hạt nhân Việt Nam. 2024; (57): 30-42.
12. Ichiki A, Carreras J, Miyaoka M, et al. Clinicopathological analysis of 320 cases of diffuse large B-cell lymphoma using the Hans classifier. Journal of clinical and experimental hematopathology. 2017; 57(2): 54-63.
13. Sun N, Qiao W, Wang T, et al. Prognostic value of interim PET/CT in GCB and non-GCB DLBCL: comparison of the Deauville five-point scale and the ΔSUVmax method. BMC cancer. 2024; 24(1): 1583.
14. Nowakowski GS, Hong F, Scott DW, et al. Addition of lenalidomide to R-CHOP improves outcomes in newly diagnosed diffuse large B-cell lymphoma in a randomized phase II US intergroup study ECOG-ACRIN E1412. Journal of Clinical Oncology. 2021; 39(12): 1329-1338.
15. Shi Y, Xu Y, Shen H, et al. Advances in biology, diagnosis and treatment of DLBCL. Annals of Hematology. 2024; 103(9): 3315-3334.