Difference of Clinical Parameters between Limited and Advanced Stage DLBCL

Background

Limited stage of diffuse large B cell lymphoma (DLBCL) is thought to have a different biology in comparison with the advanced stage, which has good prognostic factors and shows a late relapse pattern. The purpose of this study was to investigate the difference of clinical parameters between limited and advanced stage DLBCL.

Methods

Of the DLBCL patients enrolled in the Asan Medical Center's lymphoma database from January 2001 to December 2014, 997 patients who used R-CHOP as initial therapy were selected and a single institutional retrospective analysis was performed.

Results

Of the 997 patients who were diagnosed with DLBCL and initially treated with R-CHOP, 397 (39.8%) were in the limited stage (Ann Arbor stage I, II localized), and 600 (60.2%) were in the advanced stage (Ann Arbor stage II disseminated ± bulky (≥7.5cm), III, IV). The median follow-up period was 12.1 years. LDH ratio (≤1, >1 to ≤3, >3), increased β2M (β₂-microglobulin), ECOG PS≥2 were associated with advanced stage (p<.001). However, there was no difference in the tendency of early relapse (within 5 years) between limited and advanced stages in patients with relapse or progression. Germinal center B-cell like (GCB) subtype (n=261) and non-GCB (n=535) were classified by the Hans algorithm.

Conclusions

Limited stage DLBCL had relatively favorable clinical factors than the advanced DLBCL, such as age, ECOG performance status, cell of origin. Limited stage DLBCL may have different disease biology compared with advanced stage DLBCL.