Concordant Bone Marrow Involvement May Lead to Worse Outcomes in DLBCL

Concordant bone marrow (BM) involvement in patients diagnosed with diffuse large B cell lymphoma (DLBCL) is associated with worse clinical outcomes, according to findings published in Leukemia.¹

DLBCL varies in its biologic, clinical, and prognostic presentations, making it crucial to determine disease characteristics to drive therapeutic decisions. This study evaluated the impact of BM involvement in DLBCL outcomes.

The retrospective study enrolled 712 patients with DLBCL, 263 of whom presented with BM involvement and 449 who did not. All patients had already been treated with first-line rituximab containing chemotherapy.

Of the 263 patients who had positive BM involvement, 66% of patients had concordant BM.

Five-year overall survival (OS) in patients with concordant BM involvement was 42.3% vs 67.7% in patients with negative BM (P < .001). Five-year progression free survival (PFS) in patients with concordant BM was 37.2% vs 60.6% in patients with negative BM (P = <.001).

Patients with concordant BM involvement also had significantly worse outcomes than BM-negative patients with advanced DLBCL (5-year OS: 42.3% vs 57.2%, P = .007; 5-year PFS: 37.2% vs 51.5%, P = .002).

The authors concluded that the findings of the study “suggest that DLBCL with concordant BM involvement constitutes a distinct subset with unfavorable gene expression signatures, high-risk clincopathologic features, and poor prognosis.”

Reference

1. Yao Z, Deng L, Xu-Monette ZY, et al. Concordant bone marrow involvement of diffuse large B-cell lymphoma represents a distinct clinical and biological entity in the era of immunotherapy. Leukemia. 2017 Jul 12. doi: 10.1038/leu.2017.222 [Epub ahead of print]