Secondary Prognostic Index in RefrActory Lymphoma

Secondary Prognostic Index in RefrActory Diffuse Large B Cells Lymphoma

60% of patients with diffuse large B cell lymphoma are healed after first-line treatment which whatever the age. For the remaining 40% of patients (relapses and primary refractories):

• 38% of patients will be cured with a 2nd line including an autologous haematopoietic cell transplantation for those under 65 years.
• for older patients who are not eligible for a autograft: only 70% of patients will be able to receive 2nd line treatment with rates response less than 50%.
• the survival rate in patients receiving 3rd line treatment or more is 15% at 2 years. Actually, no standard of chemotherapy is offered to relapsed or refractory patients after 2 therapeutic lines. Subsequent lines lead to hospitalizations for infectious complications or transfusions without clear clinical benefit with often an impacted quality of life.

Palliative care is rarely offered as part of the treatment overall load.

Inclusion Criteria:

• Age > 18 years old
• died of diffuse large B cell lymphoma
• Refractory or relapsing after 2 treatment lines for young patients (RCHOP then recovery with platinum salts and autograft) and one line for elderly patients (RCHOP)

Exclusion Criteria:

• patients with HIV infection
• solid tumor treated less than 5 years ago with the exception of skin carcinoma or carcinoma in situ of the uterine cervix treated locally
• inclusion in a therapeutic trial