The monoclonal antibody rituximab has changed the natural history of Diffuse Large B-cell Lymphoma (DLBCL). Recent data show that patients with DLBCL achieving EFS24 (event-free survival at 24 months) after treatment with immunochemotherapy have a normal life expectancy. We have explored what happens in our patient population.
We reviewed our database of patients with lymphoma treated between 1987 and 2011. We selected DLBCL patients who had received a minimum follow up of 5 years. We included 228 patients in the analysis; 100 had received rituximab based treatment and 128 did not receive any antibody. We studied the pattern of relapse and event-free survival at 12 and 24 months from diagnosis in both populations.
Our data show that the pattern of relapse in DLBCL patients has changed in the post-rituximab era. There are fewer relapses (24% versus 33%, p = 0,04) but those who relapse do so earlier: 75% of relapse occur in the first two years and late relapse (after 5 years) are rare (less than 8%) in rituximab treated patients. Patients who achieve EFS12 have a better prognosis than patients who did not achieve it (80% OS 5 years versus 15%, p
Most of the patients who relapse after immunochemotherapy do so early, probably linked to a different biological behavior of the tumor. Patients who achieve EFS24 have a very good prognosis. We need to perform an accurate follow up with patients in the first 2 years after diagnosis to detect early relapses and focus on studying the molecular biology of these tumours to detect differences in relapsed patients. Follow up after 5 years from diagnosis will detect only a small account of relapses and probably will not impact on survival.
Clinical trial identification
Legal entity responsible for the study
Hospital Puerta de Hierro Majadahonda
All authors have declared no conflicts of interest.