EHA 2018 | Impact on outcomes of patients with DLBCL with concurrent FL or other low-grade lymphoma

On Sunday 17^th June an oral abstract session took place at the 23^rd Congress of the European Hematology Association (EHA). Abstract S1547 was presented by Yucai Wang, Mayo Clinic, Rochester, US, on the impact of concurrent follicular lymphoma (FL) or other low-grade lymphoma on the clinical outcomes of diffuse large B-cell lymphoma (DLBCL). The study aimed to compare clinical characteristics and outcomes of patients with concurrent lymphoma or de novo DLBCL.

Study Overview

• The study included patients with newly diagnosed DLBCL at the Mayo Clinic or University of Iowa from March 2002 to April 2015
• N = 1521 patients in the study had a diagnosis of:
  • de novo DLBCL (n = 1262, 87.2%)
  • DLBCL with concurrent FL (DLBCL+FL), (n = 113, 7.8%)
  • DLBCL with concurrent other low-grade B-cell lymphoma (DLBCL+LG), (n = 73, 5%)
• Of the 113 patients with DLBCL+FL, 23% had discordant pathology 
• Of the 73 patients with DLBCL+LG, the histology included; marginal zone lymphoma (24.7%), chronic lymphocytic leukemia (19.2%), lymphoplasmacytic lymphoma (5.5%) and unspecified (50.7%)

Key Findings

• Median event-free survival (EFS):
  • DLBCL+FL vs DLBCL = 145.9 vs 101.9 months, P = 0.049
  • DLBCL+LG vs DLBCL = 63.0 vs 101.9 months, P = 0.269
• 24-month EFS:
  • DLBCL+FL vs DLBCL = 74.5% vs 63.9%
  • DLBCL+LG vs DLBCL = 65.8% vs 63.9%
• Median overall survival (OS)
  • DLBCL+FL vs DLBCL = not reached vs 139.7 months, P = 0.004
  • DLBCL+LG vs DLBCL = 120.7 vs 139.7 months, P = 0.624

Dr Wang concluded that patients with DLBCL+FL at diagnosis mainly had Germinal center B-cell like (GCB) subtype, lower IPI scores and improved EFS and OS compared with de novo DLBCL patients. He added that DLBCL+FL is likely to behave similar to GCB DLBCL and that this should be taken into consideration when including these patients in DLBCL clinical trials.