Hans-Based Cell of Origin Is Not of Prognostic Significance in Diffuse Large B-Cell Lymphoma Patients: A Retrospective Single-Center Study Conducted in 326 RCHOP-Treated Patients.

Abstract

Introduction: Diffuse large B-cell lymphoma (DLBCL) is a highly aggressive lymphoma with dismal outcome after disease progression. Individual risk assessment can stratify patients into different treatment strategies.

Methods: We retrospectively collected data from 326 DLBCL patients treated in a single center with RCHOP from 01/2000 to 06/2023. Immunohistochemistry by Han's algorithm was used to classify patients according to cell of origin (COO). The Kaplan-Meier estimator of survival and Cox regression analysis were used.

Results: Time to progression (TTP) and overall survival (OS) were not different according to COO. Univariate analysis reveals International Prognostic Index (IPI), b2-microglobulin ≥3.5 mg/L, bulky disease, and abnormal LDH, but not Han's defined COO, as the strongest predictors for progression. IPI score in multivariate analysis was the only prognostic factor for OS and together with high b2-microglobulin levels were independently prognostic factors for TTP. Accordingly, b2-microglobulin ≥3.5 mg/L was an independent prognostic factor for progression both in GC (hazard ratio [HR] 0.249 [(95% CI: 0.087-0.649), p = 0.004] and non-GC DLBCL patients (HR 0.380 [95% CI: 0.177-0.813], p = 0.011).

Conclusion: COO according to Hans index is not a significant prognostic factor for DLBCL patients, but b2-microglobulin ≥3.5 mg/L and IPI 2-5 in both GC and non-GC patients can predict individually a higher risk for progression.