Patient trajectories after diagnosis of diffuse large B-cell lymphoma—a multistate modelling approach to estimate the chance of lasting remission
(2022) In British Journal of Cancer 127(9). p.1642-1649- Abstract
Background: Achieving lasting remission for at least 2 years is a good indicator for favourable prognosis long term after Diffuse large B-cell lymphoma (DLBCL). The aim of this study was to provide real-world probabilities, useful in risk communication and clinical decision-making, of the chance for lasting remissions by clinical characteristics. Methods: DLBCL patients in remission after primary treatment recorded in the Swedish Lymphoma register 2007–2014 (n = 2941) were followed for relapse and death using multistate models to study patient trajectories. Flexible parametric models were used to estimate transition rates. Results: At 2 years, 80.7% (95% CI: 79.0–82.2) of the patients were predicted to remain in remission and 13.2% (95%... (More)
Background: Achieving lasting remission for at least 2 years is a good indicator for favourable prognosis long term after Diffuse large B-cell lymphoma (DLBCL). The aim of this study was to provide real-world probabilities, useful in risk communication and clinical decision-making, of the chance for lasting remissions by clinical characteristics. Methods: DLBCL patients in remission after primary treatment recorded in the Swedish Lymphoma register 2007–2014 (n = 2941) were followed for relapse and death using multistate models to study patient trajectories. Flexible parametric models were used to estimate transition rates. Results: At 2 years, 80.7% (95% CI: 79.0–82.2) of the patients were predicted to remain in remission and 13.2% (95% CI: 11.9–14.6) to have relapsed. The relapse risk peaked at 7 months, and the annual decline of patients in remission stabilised after 2 years. The majority of patients in the second remission transitioned into a new relapse. The probability of a lasting remission was reduced by 20.4% units for patients with IPI 4–5 compared to patients with IPI 0–1, and time in remission was shortened by 3.5 months. Conclusion: The long-term prognosis was overall favourable with 80% achieving durable first remissions. However, prognosis varied by clinical subgroups and relapsing patients seldom achieved durable second remissions.
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- author
- Ekberg, Sara ; Crowther, Michael ; Harrysson, Sara ; Jerkeman, Mats LU ; E. Smedby, Karin and Eloranta, Sandra
- organization
- publishing date
- 2022
- type
- Contribution to journal
- publication status
- published
- subject
- in
- British Journal of Cancer
- volume
- 127
- issue
- 9
- pages
- 1642 - 1649
- publisher
- Nature Publishing Group
- external identifiers
-
- scopus:85136820517
- pmid:35999271
- ISSN
- 0007-0920
- DOI
- 10.1038/s41416-022-01931-2
- language
- English
- LU publication?
- yes
- id
- a953b917-101c-4a48-8c8d-d7e8898025c4
- date added to LUP
- 2022-10-26 15:30:21
- date last changed
- 2024-06-13 15:44:15
@article{a953b917-101c-4a48-8c8d-d7e8898025c4,
abstract = {{<p>Background: Achieving lasting remission for at least 2 years is a good indicator for favourable prognosis long term after Diffuse large B-cell lymphoma (DLBCL). The aim of this study was to provide real-world probabilities, useful in risk communication and clinical decision-making, of the chance for lasting remissions by clinical characteristics. Methods: DLBCL patients in remission after primary treatment recorded in the Swedish Lymphoma register 2007–2014 (n = 2941) were followed for relapse and death using multistate models to study patient trajectories. Flexible parametric models were used to estimate transition rates. Results: At 2 years, 80.7% (95% CI: 79.0–82.2) of the patients were predicted to remain in remission and 13.2% (95% CI: 11.9–14.6) to have relapsed. The relapse risk peaked at 7 months, and the annual decline of patients in remission stabilised after 2 years. The majority of patients in the second remission transitioned into a new relapse. The probability of a lasting remission was reduced by 20.4% units for patients with IPI 4–5 compared to patients with IPI 0–1, and time in remission was shortened by 3.5 months. Conclusion: The long-term prognosis was overall favourable with 80% achieving durable first remissions. However, prognosis varied by clinical subgroups and relapsing patients seldom achieved durable second remissions.</p>}},
author = {{Ekberg, Sara and Crowther, Michael and Harrysson, Sara and Jerkeman, Mats and E. Smedby, Karin and Eloranta, Sandra}},
issn = {{0007-0920}},
language = {{eng}},
number = {{9}},
pages = {{1642--1649}},
publisher = {{Nature Publishing Group}},
series = {{British Journal of Cancer}},
title = {{Patient trajectories after diagnosis of diffuse large B-cell lymphoma—a multistate modelling approach to estimate the chance of lasting remission}},
url = {{http://dx.doi.org/10.1038/s41416-022-01931-2}},
doi = {{10.1038/s41416-022-01931-2}},
volume = {{127}},
year = {{2022}},
}