RETROSPECTIVE ANALYSIS OF CLINICO-EPIDEMIOLOGICAL FEATURES AND OUTCOMES OF DIFFUSE LARGE B CELL LYMPHOMA IN ADULT PATIENTS TREATED AT CLINICAL ONCOLOGY DEPARTMENT, AIN SHAMS UNIVERSITY HOSPITALS

Abstract

: Background: Diffuse large B‐cell lymphoma (DLBCL) is the most common subtype of non-hodgkin’s lymphoma (NHL) comprising 25-30% of all NHLs worldwide. The primary site of DLBCL is important in determining the clinical features and the disease outcomes. Aim Of The Work: Analyzing the clinical, epidemiological features and outcomes including response, toxicity, and survival rates (DFS, PFS &OS) in DLBCL adult patients treated at Ain Shams University hospitals. Patient And Methods: This retrospective study included 78 DLBCL adult patients treated at Ain shams clinical oncology department from January 2016 to December 2019. Patients’ clinical characteristics and outcomes were analyzed and categorized according to the disease primary site to nodal-only, extra-nodal-only, and both nodal & extra-nodal disease. Results: The mean age at presentation was 45.54 ±15.38 years, 48.7% were 40-60 years with female predominance (57.7%). Half of the patients had early stages (I – II). The most common extra-nodal sites were bone (35.6%) and GIT (26.7%). The median IPI score was 2, with 38.5% were of low-risk. Nodal-only DLBCL (n=33) was significantly more common in males, performance 0-1, negative B-symptoms, and low risk. Extra-nodal-only DLBCL (n=11) significantly presented in females, performance (2-4), negative B-symptoms, and equally with low, high-intermediate, and high risk. Both nodal & extra-nodal DLBCL was significantly more common in females, performance 0-1, positive B-symptoms, equally bulky and non-bulky disease, and high-risk. Complete response was achieved in 56.4% and was significantly correlated with performance (0-1), negative B-symptoms, DLBCL NOS subtype, early stages (I – II), low-risk, and received R-CHOP. The 5-year DFS, PFS, and OS were 75.2%, 83.7%, and 93.8% respectively. Higher mean PFS was observed in early stages (I – II) while OS was higher in nodal-only disease. Conclusion: Nodal-only DLBCL had a characteristic clinical presentation with better prognosis and outcomes compared to extra-nodal-only DLBCL and both nodal & extranodal DLBCL.