Abstract
Background: Patient-related factors, namely comorbidities, impact the clinical outcome of patients with diffuse large B-cell lymphoma (DLBCL). Methods: The prevalence and prognostic impact of comorbidities were examined using the validated scores Charlson Comorbidity Index (CCI) and Hematopoietic Cell Transplantation-specific Comorbidity Index (HCT-CI) in 181 patients with DLBCL
at initial diagnosis before treatment with rituximab, cyclophosphamide, vincristine, doxorubicin and prednisone (R-CHOP). Results: Pronounced comorbidities as defined by CCI and HCT-CI scoring of ≥2 were detected in 9.9% and 28.2% of patients, respectively, and occurred more frequently at
advanced age (p < 0.001). Higher CCI scoring was associated with lower complete response rate (p = 0.020). Both advanced CCI and HCT-CI were significantly associated with shortened overall survival (3-year OS: CCI ≥2 vs. 0–1, 38.9% vs. 81.3%, p < 0.001; HCT-CI ≥2 vs. 0–1, 56.9% vs. 84.9%,
p < 0.001). Both comorbidity scores remained independent risk factors in the multivariate analysis (HCT-CI ≥2 HR: 2.6, p = 0.004; CCI ≥2 HR: 3.6, p = 0.001). Conclusion: This study demonstrates the prognostic relevance of comorbidities classified by CCI and HCT-CI in patients with DLBCL undergoing curative treatment with R-CHOP. A structured evaluation of comorbidities might refine
prognostication alongside currently used prognostic parameters, namely age, and should be evaluated in prospective trials.
Original language | English |
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Article number | 1005 |
Number of pages | 12 |
Journal | Journal of clinical medicine |
Volume | 9 |
Issue number | 4 |
DOIs | |
Publication status | Published - Apr 2020 |
Externally published | Yes |
Keywords*
- comorbidities
- HCT-CI
- CCI
- DLBCL
- prognosis
- R-CHOP
Field of Science*
- 3.2 Clinical medicine
Publication Type*
- 1.1. Scientific article indexed in Web of Science and/or Scopus database