Related Experiment Video
Updated: Apr 29, 2026
Murine Model of Leukemia Relapse to Induction Chemotherapy for Acute Lymphoblastic Leukemia
Published on: October 17, 2025
Time-to-treatment of diffuse large B-cell lymphoma in São Paulo
Flávia Dias Xavier1, Debora Levy2, Juliana Pereira1
1Hematology Department, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP) and Instituto do Câncer do Estado de São Paulo (ICESP), São Paulo, SP, Brazil.
Insights
A delay in diagnosing diffuse large B-cell lymphoma (DLBCL) is a significant public health issue. Longer time-to-treatment, exceeding six months, is linked to poorer progression-free survival in DLBCL patients.
Area of Science:
- Oncology
- Hematology
- Public Health
Background:
- Diffuse large B-cell lymphoma (DLBCL) is the most common non-Hodgkin lymphoma, representing nearly 50% of cases in major São Paulo cancer centers.
- Treatment outcomes for DLBCL are multifactorial, influenced by patient age, disease stage, and performance status.
Purpose of the Study:
- To determine the time-to-treatment for DLBCL within São Paulo's public health system.
- To evaluate the impact of diagnostic and treatment delays on patient outcomes.
Main Methods:
- Prospective cohort study of 42 consecutive patients with de novo DLBCL.
- Data collected between 2008 and 2012.
Main Results:
- Patients presented with more advanced disease (61.9%) compared to literature averages.
- Average time from symptom onset to diagnosis was 7.4 months, with an additional 1.4 months to see a specialist.
- An interval exceeding 6 months from symptom onset to treatment initiation was associated with inferior 3-year progression-free survival (p = 0.049).
Conclusions:
- Diagnostic delays in DLBCL represent a critical public health concern.
- Delayed treatment initiation is significantly associated with reduced progression-free survival in DLBCL patients.
Objective:
Diffuse large B-cell lymphoma is the most common type of non-Hodgkin lymphoma, accounting for nearly 50% of the cases in the Hematology Department of the Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo and Instituto do Câncer do Estado de São Paulo. The treatment outcome is influenced by age, abnormal lactate dehydrogenase levels, extranodal infiltration, the disease stage and the patient's performance status. In this study, we sought to report the time-to-treatment of diffuse large B-cell lymphoma in São Paulo's public health system network and its impact on patient outcomes.
Methods:
We prospectively followed a cohort of 42 consecutive patients with de novo diffuse large B-cell lymphoma between 2008 and 2012.
Results:
Our patients had more advanced disease than that reported in the literature (61.9% vs. 46%). In São Paulo's public health system network, it took an average of 7.4 months for a diagnosis to be made and an additional 1.4 months to obtain an appointment with a specialist. Once at our Hematology Department, it took less than 20 days for staging, confirmation of the diagnosis and treatment initiation. An interval from signs or symptoms to treatment of more than 6 months was associated with inferior progression-free survival in 3 years (p = 0.049).
Conclusion:
A delay in the diagnosis of diffuse large B-cell lymphoma is a public health problem and may be associated with worse progression-free survival.
Related Concept Videos
02:56Treatment Resistant Cancers
01:28Pulmonary Tuberculosis V
Latent tuberculosis infection occurs when TB bacteria are present in a person's body, but are not causing illness or symptoms. It is not contagious, and preventive treatment is crucial to avoid the...