Patient trajectories after diagnosis of diffuse large B-cell lymphoma—a multistate modelling approach to estimate the chance of lasting remission

Background: Achieving lasting remission for at least 2 years is a good indicator for favourable prognosis long term after Diffuse large B-cell lymphoma (DLBCL). The aim of this study was to provide real-world probabilities, useful in risk communication and clinical decision-making, of the chance for lasting remissions by clinical characteristics. Methods: DLBCL patients in remission after primary treatment recorded in the Swedish Lymphoma register 2007–2014 (n = 2941) were followed for relapse and death using multistate models to study patient trajectories. Flexible parametric models were used to estimate transition rates. Results: At 2 years, 80.7% (95% CI: 79.0–82.2) of the patients were predicted to remain in remission and 13.2% (95% CI: 11.9–14.6) to have relapsed. The relapse risk peaked at 7 months, and the annual decline of patients in remission stabilised after 2 years. The majority of patients in the second remission transitioned into a new relapse. The probability of a lasting remission was reduced by 20.4% units for patients with IPI 4–5 compared to patients with IPI 0–1, and time in remission was shortened by 3.5 months. Conclusion: The long-term prognosis was overall favourable with 80% achieving durable first remissions. However, prognosis varied by clinical subgroups and relapsing patients seldom achieved durable second remissions.

Crowther, MichaelKarolinska Institute,Red Door Analytics (författare)
Harrysson, SaraKarolinska Institutet,Karolinska Institute,Karolinska University Hospital (författare)
Jerkeman, MatsLund University,Lunds universitet,Lymfom - Klinisk forskning,Forskargrupper vid Lunds universitet,LUCC: Lunds universitets cancercentrum,Övriga starka forskningsmiljöer,Lymphoma - Clinical Research,Lund University Research Groups,LUCC: Lund University Cancer Centre,Other Strong Research Environments,Skåne University Hospital(Swepub:lu)onk-mje (författare)
E. Smedby, KarinKarolinska Institutet,Karolinska Institute,Karolinska University Hospital (författare)
Eloranta, SandraKarolinska Institute (författare)
Karolinska InstitutetKarolinska Institute (creator_code:org_t)

Ingår i:British Journal of Cancer: Springer Science and Business Media LLC127:9, s. 1642-16490007-09201532-1827

Av författaren/redakt...: Ekberg, Sara; Crowther, Michae ...; Harrysson, Sara; Jerkeman, Mats; E. Smedby, Karin; Eloranta, Sandra

Om ämnet

MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Cancer och onkol ...

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