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Background <p>Relapsed or refractory (R/R) diffuse large B-cell lymphoma (DLBCL) exhibits substantial clinical heterogeneity, with different outcomes based on disease burden and anatomical distribution. However, the prognostic implications of multi-site involvement at first R/R remain unclear.</p> Methods <p>We retrospectively analyzed data from 81 patients with DLBCL who experienced first R/R after initial treatment at our institution. We assessed clinical variables at first R/R—including involved sites and disease dissemination patterns, lactate dehydrogenase (LDH), and Eastern Cooperative Oncology Group performance status (ECOG PS)—for associations with progression-free survival (PFS) and overall survival (OS).</p> Results <p>Multi-site involvement (≥ 2 sites) at first R/R was significantly associated with shorter PFS and OS, independent of nodal or extranodal status. In multivariable analysis, multi-site involvement at first R/R remained a strong prognostic factor for both PFS and OS, along with IPI at first R/R for PFS, and ECOG PS &gt; 1, elevated LDH, and age &gt; 80&#xa0;years for OS. None of these relapse-specific prognostic factors were significant at initial diagnosis.</p> Conclusion <p>Multi-site disease at first R/R represents an adverse prognostic feature in DLBCL. These findings underscore the importance of considering disease distribution when evaluating prognosis and planning treatment strategies for R/R cases.</p>

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Anatomical patterns at first confirmed relapse or refractory disease predict outcomes in diffuse large B-cell lymphoma

  • 期刊论文

  • 发表日期：

    2025年12月26日

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  • Hidenori Hayashi,
  • Yohei Sasaki,
  • Ayano Shirai,
  • Hirotaro Sakaki,
  • Kazuki Nagao,
  • Natsuki Kawamata,
  • Kai Kuroiwa,
  • Hinako Narita,
  • Reiko Okamura,
  • Shotaro Shimada,
  • Megumi Watanuki,
  • Nana Arai,
  • Kouji Yanagisawa,
  • Manabu Matsunawa,
  • Norimichi Hattori

摘要

Background

Relapsed or refractory (R/R) diffuse large B-cell lymphoma (DLBCL) exhibits substantial clinical heterogeneity, with different outcomes based on disease burden and anatomical distribution. However, the prognostic implications of multi-site involvement at first R/R remain unclear.

Methods

We retrospectively analyzed data from 81 patients with DLBCL who experienced first R/R after initial treatment at our institution. We assessed clinical variables at first R/R—including involved sites and disease dissemination patterns, lactate dehydrogenase (LDH), and Eastern Cooperative Oncology Group performance status (ECOG PS)—for associations with progression-free survival (PFS) and overall survival (OS).

Results

Multi-site involvement (≥ 2 sites) at first R/R was significantly associated with shorter PFS and OS, independent of nodal or extranodal status. In multivariable analysis, multi-site involvement at first R/R remained a strong prognostic factor for both PFS and OS, along with IPI at first R/R for PFS, and ECOG PS > 1, elevated LDH, and age > 80 years for OS. None of these relapse-specific prognostic factors were significant at initial diagnosis.

Conclusion

Multi-site disease at first R/R represents an adverse prognostic feature in DLBCL. These findings underscore the importance of considering disease distribution when evaluating prognosis and planning treatment strategies for R/R cases.