Prognostic value of pretreatment anemia in patients with diffuse large B-cell lymphoma treated with R-CHOP

Tải xuống

Dữ liệu tải xuống chưa có sẵn.
PDF (English) Download: 0 View: 0

Indexing

CÁC SỐ TỪ 2011-2023
Tạp chí Y Dược Học

Tóm tắt

ABSTRACT

Background: Diffuse Large B-Cell Lymphoma (DLBCL) is the most common subtype of non-Hodgkin lymphoma. While R-CHOP is the standard of care, treatment failure remains a challenge. Pretreatment anemia is a common paraneoplastic manifestation, yet its prognostic utility in Vietnamese patients remains under-investigated.

Materials and Methods: A combined prospective and retrospective study was conducted on 106 patients with CD20-positive DLBCL treated with first-line R-CHOP at Hue University of Medicine and Pharmacy Hospital, Hue Central Hospital and Da Nang Oncology Hospital from December 2022 to August 2025. Pretreatment anemia was classified according to NCI-CTCAE v5.0. Clinicopathological features, toxicity, treatment response, and survival were analyzed.

Results: The prevalence of pretreatment anemia was 32.1%, with the majority being Grade 1 (26.4%). Anemia was significantly associated with B symptoms (p=0.034) and older age (p=0.039). Regarding efficacy, non-anemic patients had approximately 12 times higher odds of responding (Odds Ratios = 11.897; 95% CI: 1.33–106.34, p = 0.014). Toxicity analysis showed a 3.8% treatment-related mortality rate due to severe infections. There was no statistically significant difference in overall survival or progression-free survival (p > 0.05).

Conclusion: Pretreatment anemia is a robust and easily accessible predictor of poor early treatment response in Vietnamese patients with DLBCL treated with R-CHOP. Anemic patients have significantly lower odds of achieving remission. While long-term survival benefits were obscured by treatment-related toxicity in this cohort, the strong link between hemoglobin levels and therapeutic efficacy suggests that anemia should be integrated into risk stratification.

https://doi.org/10.34071/jmp.2026.2.860
Đã xuất bản 30-04-2026
Toàn văn
PDF (English) Download: 0 View: 0
Ngôn ngữ
Số tạp chí Tập 16 Số 02 (2026)
Phân mục Nghiên cứu
DOI 10.34071/jmp.2026.2.860
Từ khóa Anemia, RCHOP, Prognosis, Diffuse Large B-Cell Lymphoma

Creative Commons License

công trình này được cấp phép theo Creative Commons Attribution-phi thương mại-NoDerivatives 4.0 License International .

Bản quyền (c) 2026 Tạp chí Y Dược Huế

Nguyen, T. T., Nguyen, T. L., Phan, M. T., & Phan, T. D. Q. (2026). Prognostic value of pretreatment anemia in patients with diffuse large B-cell lymphoma treated with R-CHOP. Tạp Chí Y Dược Huế, 16(02), 57–62. https://doi.org/10.34071/jmp.2026.2.860

Bray F, Laversanne M, Sung H, Ferlay J, Siegel RL, Soerjomataram I, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2024;74(3):229-63.

Harrysson S, Eloranta S, Ekberg S, Enblad G, Jerkeman M, Hasselblom S, et al. Incidence of Relapsed/Refractory Diffuse Large B-Cell Lymphoma (DLBCL) Including CNS Relapse in a Population-Based Cohort of 4205 Patients in Sweden. Blood. 2019;134(Supplement_1):399-.

Dogliotti I, Peri V, Clerico M, Vassallo F, Musto D, Mercadante S, et al. Real life clinical outcomes of relapsed/refractory diffuse large B cell lymphoma in the rituximab era: The STRIDER study. Cancer Medicine. 2024;13(14):e7448.

Jiang S, Qin Y, Liu P, Yang J-L, Yang S, He X, et al. Prognostic Nomogram and Predictive Factors in Refractory or Relapsed Diffuse Large B-Cell Lymphoma Patients Failing Front-Line R-CHOP Regimens. Journal of Cancer. 2020;11:1516-24.

Project TIN-HsLPF. A predictive model for aggressive non-Hodgkin's lymphoma. N Engl J Med. 1993;329(14):987-94.

Madeddu C, Gramignano G, Astara G, Demontis R, Sanna E, Atzeni V, et al. Pathogenesis and Treatment Options of Cancer Related Anemia: Perspective for a Targeted Mechanism-Based Approach. Frontiers in Physiology. 2018;9.

Lee P, Koseki L, Haitani T, Harada H, Kobayashi M. Hypoxia-Inducible Factor-Dependent and Independent Mechanisms Underlying Chemoresistance of Hypoxic Cancer Cells. Cancers. 2024;16.

Magar AG, Morya VK, Kwak MK, Oh JU, Noh KC. A Molecular Perspective on HIF-1α and Angiogenic Stimulator Networks and Their Role in Solid Tumors: An Update. Int J Mol Sci. 2024;25(6).

Hong J, Woo HS, Kim H, Ahn HK, Sym SJ, Park J, et al. Anemia as a useful biomarker in patients with diffuse large B-cell lymphoma treated with R-CHOP immunochemotherapy. Cancer Sci. 2014;105(12):1569-75.

Troppan KT, Melchardt T, Deutsch A, Schlick K, Stojakovic T, Bullock MD, et al. The significance of pretreatment anemia in the era of R-IPI and NCCN-IPI prognostic risk assessment tools: a dual-center study in diffuse large B-cell lymphoma patients. Eur J Haematol. 2015;95(6):538-44.

Matsumoto K, Fujisawa S, Ando T, Koyama M, Koyama S, Ishii Y, et al. Anemia Associated with Worse Outcome in Diffuse Large B-Cell Lymphoma Patients: A Single-Center Retrospective Study. Turk J Haematol. 2018;35(3):181-4.