Real-world outcomes following third or subsequent lines of therapy: A Danish population-based study on 189 patients with relapsed/refractory large B-cell lymphomas

Ahmed Ludvigsen AL-Mashhadi*, Lasse Hjort Jakobsen, Peter Brown, Anne Ortved Gang, Anne Luise Thorsteinsson, Kaziwa Rasoul, Judith Melchior Haissman, Michael Buch Tøstesen, Mette Niemann Christoffersen, Jelena Jelicic, Jennifer Bøgh Jørgensen, Troels Thomsen, Andriette Dessau-Arp, Andreas P.H. Andersen, Mikael Frederiksen, Per Trøllund Pedersen, Michael Roost Clausen, Judit Meszaros Jørgensen, Christian Bjørn Poulsen, Tarec Christoffer El-GalalyThomas Stauffer Larsen

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

Outcome data of patients with relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL) beyond the second line are scarce outside of clinical trials. Novel therapies in the R/R setting have been approved based on single-arm trials, but results need to be contextualized by real-world outcomes. Medical records from 3753 Danish adults diagnosed with DLBCL were reviewed. Patients previously treated with rituximab and anthracycline-based chemotherapy who received the third or later line (3 L+) of treatment after 1 January 2015, were included. Only 189 patients with a median age of 71 years were eligible. The median time since the last line of therapy was 6 months. Patients were treated with either best supportive care (22%), platinum-based salvage therapy (13%), low-intensity chemotherapy (22%), in clinical trial (14%) or various combination treatments (32%). The 2-year OS-/PFS estimates were 25% and 12% for all patients and 49% and 17% for those treated with platinum-based salvage therapy. Age ≥70, CNS involvement, elevated LDH and ECOG ≥2 predicted poor outcomes, and patients with 0–1 of these risk factors had a 2-year OS estimate of 65%. Only a very small fraction of DLBCL patients received third-line treatment and were eligible for inclusion. Outcomes were generally poor, but better in intensively treated, fit young patients with limited disease.

Original languageEnglish
JournalBritish Journal of Haematology
Volume204
Issue number3
Pages (from-to)839-848
ISSN0007-1048
DOIs
Publication statusPublished - Mar 2024

Keywords

  • chemotherapy
  • clinical research
  • epidemiology
  • lymphomas
  • malignant lymphomas
  • Humans
  • Lymphoma, Non-Hodgkin/drug therapy
  • Antineoplastic Combined Chemotherapy Protocols/therapeutic use
  • Lymphoma, Large B-Cell, Diffuse/drug therapy
  • Denmark
  • Adult
  • Aged
  • Rituximab/therapeutic use

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