International Journal of Hematology and Oncology 2018, Vol 28, Num 4 Page(s): 248-253
The Impact of Bulky Mass on Treatment Response and Overall Survival in Patients with Diffuse Large B-Cell Lymphoma in Rituximab Era

Rafet EREN1, Muzaffer Ece HAKAN2, Ceyda ASLAN3, Mehmet Hilmi DOGU3, Sermin ALTINDAL3, Osman YOKUS3, Elif SUYANI3

1University of Health Sciences, Okmeydanı Training and Research Hospital, Department of Hematology, İstanbul, TURKEY
2University of Health Sciences, İstanbul Training and Research Hospital, Department of Internal Medicine, İstanbul, TURKEY
3University of Health Sciences, İstanbul Training and Research Hospital, Department of Hematolgy, İstanbul, TURKEY

Keywords: Diffuse large B cell lymphoma, Bulky mass, Rituximab
We aim to evaluate the prognostic value of the presence of bulky mass at the time of diagnosis in patients with diffuse large B cell lymphoma (DLBCL) receiving R-CHOP chemotherapy. The data of 86 patients were analyzed retrospectively. The patients were divided into 2 groups according to the presence of bulky mass. The impact of bulky disease on treatment response and overall survival (OS) in patients receiving R-CHOP therapy was assessed. Twenty five (28.7%) patients had bulky disease. Sixteen of 25 patients (64%) with bulky mass achieved CR, whereas 53 of 59 patients (90%) without bulky mass achieved CR (p= 0.015). Within a median 17 months (range, 3-86) of follow up period, 16 (18.6%) of the patients died. Among them, 9 patients had bulky disease. The probability of OS at the end of follow-up time was 54% in patients with bulky disease and 87% in patients without bulky disease (p= 0.007). Cox regression analysis showed that the presence of bulky disease had a negative impact on OS (p= 0.012); however this effect was not independent of IPI (p= 0.078). We found that the presence of bulky mass is a poor prognostic factor in DLBCL patients treated with R-CHOP regimen.