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Retrospective analysis of diffuse large B-cell lymphoma treated with the R-CHOP regimen at a Malaysian tertiary
Alvin Jung Mau Chai1, Tze Shin Leong2, Grace Wan Chieng Lee2
1Haematology Unit, Department of Medicine, Sarawak General Hospital, Ministry of Health Malaysia, Kuching, Malaysia. alvincjm@yahoo.com.
Background:
Diffuse large B-cell lymphoma, not otherwise specified (DLBCL, NOS), is an aggressive malignancy and the most prevalent subtype of lymphoma both globally and in Malaysia. This study aimed to assess the clinical course, treatment response to the R-CHOP regimen (rituximab, cyclophosphamide, vincristine, doxorubicin, and prednisolone), and survival outcomes of patients diagnosed with DLBCL at a tertiary care center.
Methods:
A retrospective analysis was conducted on patients diagnosed with de novo DLBCL between 2015 and 2020. Demographic profiles, clinical features, treatment information, and outcomes were systematically collected and evaluated.
Results:
A total of 202 patients were analyzed, with a median age of 58 years (interquartile range: 20). The majority were male (58.4%). The median follow-up period was 50.1 months (interquartile range: 64.6). All patients received at least one cycle of the R-CHOP regimen. Following chemotherapy, 6.9% of patients underwent radiotherapy as a consolidative approach. A complete response was achieved in 57.9% of cases. The three-year overall survival (OS) and progression-free survival (PFS) rates were 60.9% and 58.4%, respectively. Patients with higher International Prognostic Index scores demonstrated significantly poorer OS and PFS than those with lower scores (p < 0.0001 for both). The presence of B symptoms was also associated with inferior OS and PFS (p = 0.047 and 0.044, respectively). Furthermore, hypoalbuminemia (serum albumin < 35 g/L) emerged as an independent prognostic indicator linked to reduced OS in multivariate analysis (p = 0.0040).
Conclusions:
This study provides key insights into the clinical characteristics and treatment outcomes of Malaysian patients with DLBCL managed with the R-CHOP regimen. Age, presence of B symptoms, disease stage, baseline serum albumin, and lactate dehydrogenase levels were identified as significant prognostic markers that may help predict survival in newly diagnosed DLBCL cases. Larger, prospective trials with prolonged follow-up are necessary to validate these findings.
