background:Diffuse large b-cell lymphoma(DLbCL)patients refractory to rituximab-based immunochemotherapy have a dismal ***,the definition of refractory DLbCL remains inconsistent and no large cohort study data is avai...
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background:Diffuse large b-cell lymphoma(DLbCL)patients refractory to rituximab-based immunochemotherapy have a dismal ***,the definition of refractory DLbCL remains inconsistent and no large cohort study data is available from Asian *** validate the definition and outcomes of refractory DLbCL in China,we conducted a multicenter,retrospective cohort ***:The REtrospective AnaLysis of Treatment REspoNse of refractory DLbCL(REAL-TREND)study was performed using real-world data from 8 centers in *** patients with curative intent were included in the REAL-TREND *** survival(Os)was estimated using the Kaplan-Meier method and compared by the log-rank *** to heterogeneity in response rates among different centers,the response rates of refractory patients were pooled using random-effect *** survival analysis was performed using the Cox regression ***:A total of 2778 DLbCL patients diagnosed between january,2010 and December,2015 were enrolled to this *** validating previous definitions,the sChOLAR-1 study was most suitable to define refractory *** estimated 5-year cumulative incidence of refractory patients was 20%(95% confidence Interval[CI]=18%-22%).After the determination of refractory disease,overall response rate and complete remission rate were 30%(95%CI=22%-38%)and 9%(95%CI=4%-15%),*** with either no response to immunochemotherapy or relapse within 12 months after stem-cell transplantation had inferior survival with a median Os of 5.9 months(95%CI=5.5-7.1 months)and 2-year Os rate of 16%(95%CI=12%-20%).International prognostic index score 4-5(hazard ratio[hR]=2.22;95%CI=1.47-3.35),central nervous systemrelapse(hR=1.43;95%CI=1.04-1.97),and best response status(hR=2.68;95%CI=1.42-5.03 for partial ***=5.97,95%CI=3.21-11.11 for stable disease/progressive disease)were independent unfavorable prognostic ***:This is the first large-scale
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