Event-free survival at 12 months is a strong surrogate endpoint for stage 1 diffuse large B cell lymphoma: a report from Nation Wide Registry Thai Lymphoma Study Group

Abstract

Event-free survival at 12 months (EFS12) is a surrogate endpoint for long-term outcomes in many histologic lymphoma subtypes. However, most reports have primarily investigated the implication of EFS12 in advanced-stage non-Hodgkin lymphoma (NHL). There are limited data regarding the significance of EFS12 in early-stage NHL. Herein, we evaluated the prognostic significance of EFS12 in patients with stage 1 diffuse large B-cell lymphoma (DLBCL). Out of 282 patients with stage 1 DLBCL who received intensive therapy, 227 (80.5%) achieved EFS12. The 4-year overall survival (OS) was 91.4% and 4.0% for patients who achieved and failed to achieve EFS12, respectively. Multivariable analyses demonstrated response to treatment and achievement of EFS12 as independent predictors for OS. In conclusion, our study demonstrated EFS12 as a powerful prognostic factor for stage 1 DLBCL. Further validation in more extensive prospective studies is warranted.

Keywords:

• Survival
• diffuse large B-cell lymphoma
• prognosis
• EFS12
• risk stratification

Ethical approval

The institutional review board committee at each participation site approved the study. All patients provided informed consent granting the investigator to abstract their medical information for research purposes.

Acknowledgements

The authors thank Dr. Mrinal S Patnaik from Mayo Clinic and Dr. Theodora Anagnostou from Memorial Sloan Kettering for their help on English editorial comments and grammatic correction. We appreciate the effort of the TLSG project managers, research staffs, registered nurses, and data managers from each participating site of Thai Lymphoma Study Group for their dedication. We are extremely grateful to all patients and their family who granted their consents to be enrolled into the registry. K.W. received salary support from the Parker Institute for Cancer Immunotherapy at the Memorial Sloan Kettering Cancer Center.

Disclosure statement

The authors declare that they have no conflict of interest.

Author contributions

K.W. contributes in all steps of the study: study concept, study design, data acquisition, quality control data, data analysis, statistical analysis, manuscript preparation, manuscript editing and manuscript review. U.B. contributes to study concept, study design, quality control data, statistical analysis, manuscript preparation, editing and review. J.W. contributes to study concept, data acquisition, data analysis, statistical analysis, manuscript preparation, editing and review. A.L. contributes to study concept, data analysis, manuscript preparation, editing and review. S.E. contributes to data acquisition, quality control data, manuscript preparation, editing and review. A.K. contributes to study concept, data interpretation, manuscript preparation, editing and review. S.C. study concept, data interpretation, manuscript preparation, editing and review. P.N. contributes to study concept, data acquisition, manuscript preparation, editing and review. T.N. contributes to manuscript preparation, editing and review. K.P. contributes to data acquisition, manuscript preparation, editing and review. N.K. contributes to data acquisition, manuscript preparation, editing and review. S.W. contributes to data acquisition, manuscript preparation, editing and review. N.M. contributes to data acquisition, manuscript preparation, editing and review. P.W. contributes to data acquisition, manuscript preparation, editing and review. L.N. contributes to quality control data, manuscript preparation, editing and review. W.N. contributes to manuscript preparation, editing and review. K.C. contributes to manuscript preparation, editing and review. C.S. contributes to manuscript preparation, editing and review. T.S. contributes to data acquisition, manuscript preparation, editing and review. P.P. contributes to manuscript preparation, editing and review. T.I. contributes to study concept, study design, data analysis, data interpretation, manuscript preparation, editing and review. All authors have approved the final article.

Additional information

Funding

This study was partly supported by research grant from Research Unit in Translational Hematology Chulalongkorn University and registry-based study grant from Thai Lymphoma Study Group Thai Society of Hematology.