Patients with diffuse large B-cell lymphoma (DLBCL) with a specific disease characteristic are expected to have poor clinical outcomes, according to research published in Leukemia (published online July 12, 2017; doi:10.1038/leu.2017.222).
DLBCL is manifested differently on a patient-to-patient basis in terms of biologic, clinical, and prognostic features. Thus, identifying disease characteristics that correlate with improved outcomes from specific therapeutic options is crucial to optimal treatment. The clinical and biological significance of one such characteristic—bone marrow involvement—has not been thoroughly investigated in DLBCL.
A group of multinational researchers conducted a retrospective study to evaluate the impact of bone marrow involvement in DLBCL outcomes. A total of 712 patients with DLBCL were enrolled, 263 of whom demonstrated bone marrow involvement and 449 of whom were bone marrow-negative. All patients had been previously treated with first-line rituximab containing chemotherapy.
Among the 263 patients in the bone marrow involvement cohort, 66% had concordant bone marrow.
Researchers assessed for overall survival (OS) and progression-free survival (PFS) in patients with concordant bone marrow involvement compared with those with negative bone marrow.
Results of the study showed that median five-year OS in patients with concordant bone marrow involvement was 42.3%, compared with 67.7% in patients with negative bone marrow. Similarly, median five-year PFS for patients in the concordant bone marrow involvement cohort was 37.2%, compared with 60.6% for patients in the negative bone marrow cohort.
Additionally, researchers noted that patients with advanced DLBCL in the concordant bone marrow involvement cohort exhibited significantly worse survival outcomes than those with advanced disease in the negative bone marrow cohort (5-year OS, 42.3% vs 57.2%, respectively; P = .007; 5-year PFS; 37.2% vs 51.5%, respectively; P = .002).
Researchers concluded that “concordant [bone marrow] involvement represents a distinct subset [of patients with DLBCL] with unfavorable gene signatures, high-risk clinicopathologic features, and poor prognosis.”—Zachary Bessette
