The impact of clinical manifestations on the prognosis of diffuse large B-cell lymphoma

Abstract

Objective: This study aimed to investigate the recurrence patterns of diffuse large B-cell lymphoma (DLBCL) and assess the significance of clinical manifestation consistency at the time of recurrence. Methods: A total of 141 patients who were newly diagnosed with DLBCL between January 2015 and October 2024 and who initially achieved complete remission but eventually developed relapsed disease during follow-up were retrospectively identified, their recurrence circumstances were assessed, and their clinical manifestations at diagnosis and recurrence were compared. The timing of recurrence was categorized as within 1 year of postchemotherapy or later. Results: A total of 113 (80.1%) patients presented with clinical manifestations leading to the diagnosis of recurrence. A total of 87 (61.7%) patients presented similar clinical manifestations at recurrence to those observed during initial diagnosis. Importantly, for patients who relapsed within 1 year of chemotherapy, those with inconsistent manifestations at recurrence had significantly poorer prognoses and lower survival rates (complete remission (CR) rate, 7.4%; 1-year overall survival (OS), 37.5%; 1-year progression-free survival (PFS), 18.5%) than those with consistent manifestations (CR rate, 20.8%; 1-year OS, 34.0%; 1-year PFS, 22.6%; PFS, p = 0.046; OS, p = 0.049). In contrast, for patients whose recurrence occurred more than 1 year postchemotherapy, consistent manifestations were associated with better survival outcomes (CR rate, 44.1%; 1-year OS, 61.8%; 1-year PFS, 52.9%). Conclusion: The timing of recurrence and the consistency of clinical manifestations are important factors influencing the prognosis of DLBCL. Specifically, early recurrence with inconsistent manifestations is associated with worse outcomes, whereas recurrence with consistent manifestations 1 year postchemotherapy is correlated with an improved prognosis.