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Leuk Lymphoma. 2018 Oct 2:1-7. doi: 10.1080/10428194.2018.1515944. [Epub ahead of print]

Efficacy of salvage chemotherapy in diffuse large B cell lymphoma with primary treatment failure according to putative cell of origin.

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a Division of Hematology and Oncology , Medical College of Wisconsin , Milwaukee , WI , USA.
b Department of Medicine, Division of Hematology, Oncology and Transplantation , University of Minnesota , Minneapolis , MN , USA.
c Division of Hematology, Department of Internal Medicine , The James Cancer Hospital and Solove Research Institute at The Ohio State University , Columbus , OH , USA.
d Division of Hematology and Oncology , University of Vermont Cancer Center , Burlington , VT , USA.
e Division of Malignant Hematology , H. Lee Moffitt Cancer Center & Research Institute , Tampa , FL , USA.
f Dept. of Pediatrics , University of Alabama , Birmingham , AL , USA.
g Department of Internal Medicine , Rush University , Chicago , IL , USA.
h Division of Hematology and Oncology , UMASS Memorial Medical Center , Worcestor , MA , USA.
i Division of Hematology and Oncology , Vanderbilt University Medical Center , Nashville , TN , USA.
j Department of Internal Medicine , Huntsman Cancer Institute, University of Utah , Salt Lake City , UT , USA.
k Department of Medicine and Immunology , Roswell Park Cancer Institute , Buffalo , NY , USA.
l Department of Hematology and Medical Oncology , Winship Cancer Institute, Emory University , Atlanta , GA , USA.
m Division of Hematology and Oncology , Tufts University School of Medicine and Cancer Center , Boston , MA , USA.
n Department of Hematology and Oncology , City of hope , Los angeles , CA , USA.
o Dartmouth-Hitchcock Medical Center , Lebanon , NH , USA.
p Department of Hematology and Oncology , Fox Chase Cancer Center, Temple Health , Philadelphia , PA , USA.
q Department of Medicine , University of Alabama , Birmingham , AL , USA.


We evaluated outcome of 235 primary treatment failure (PTF) diffuse large B-cell lymphoma (DLBCL) patients based on salvage chemotherapy regimen and putative cell-of-origin (COO). Patients were divided into two groups; group A (n = 38) received high-dose cytarabine containing regimen, either DHAP or ESHAP. Patients in group B (n = 197) received ifosfamide, carboplatin, and etoposide (ICE) +/- rituximab. No difference in overall response rates (CR + PR) was observed based on salvage chemotherapy regimen and COO. After adjustment for the presence of ultra high-risk features, overall survival of germinal center B-cell like (GCB) DLBCL patients in group A was not significantly different from survival in group B (HR 0.86, 95% CI 0.46-1.60, p = .64). Similarly, within non-GCB DLBCL cohort, survival in group A was comparable to group B (HR 0.53, 95% CI 0.20-1.44, p = .21). We did not find an outcome difference between two commonly used salvage chemotherapy regimens in patients with PTF DLBCL based on COO.


Refractory diffuse large B-cell lymphoma; germinal center B-cell like DLBCL; putative cell-of-origin

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