Diffuse large B-cell lymphoma: A retrospective study from a regional care center in South India.

Introduction: Diffuse large B-cell lymphoma (DLBCL) is an aggressive lymphoma whose outcomes have significantly improved with rituximab in addition to anthracycline-based chemotherapy.

Objective: This study aimed to study the epidemiology, treatment, and outcomes of patients with DLBCL.

Materials and Methods: A total of 526 patients diagnosed with DLBCL between 2006 and 2015 were retrospectively analyzed.

Results: The median age was 50 years with a male preponderance. Two hundred and twenty-three (42.39%) patients presented with B symptoms. A total of 53 (10.07%) patients presented with bulky disease and 202 (31.40%) with extranodal disease. The most common extranodal sites involved were the stomach (20.79%) and the bone marrow (10.89%). Bone marrow involvement was seen in only 22 (4.18%) cases. The distribution of patients presenting in low, low-intermediate, high-intermediate, and high-risk International Prognostic Index (IPI) were 148 (28.13%), 191 (36.31%), 124 (23.57%), and 63 (11.97%), respectively. The median survival of the entire cohort was 22 months. Survival of patients that compared the two groups with respect to the IPI - one having clubbed patients in low and low/intermediate risk and the other clubbing high/intermediate and high risk showed significantly improved survival in the lower risk groups - 24 versus 18 months (P = 0). The survival of those who received chemoimmunotherapy i.e R - CHOP was significantly better than those who received chemotherapy (CHOP) alone - 33 versus 21 months (P = 2.22e-16).

Conclusions: DLBCL is one of the most common lymphomas seen in our daily practice. Outcomes are significantly inferior compared to western countries. Biological and patient-related factors such as nongerminal center B subtype, higher extranodal involvement, and poor tolerability to treatment could contribute to inferior outcomes.