The influence of GCB and Non-GCB subtypes based on the Hans algorithm on 2 Year event free survival in diffuse large B-cell lymphoma patients who received RCHOP therapy

Abstrak

Background: Diffuse large B cell lymphoma (DLBCL) is the most common subtype of non-Hodgkin's lymphoma. Based on the Hans algorithm, DLBCL is divided into two main subtypes, namely Germinal Center B-Cell-like (GCB) and non-GCB. GCB has a better prognosis than non-GCB subtypes. Research Objective: To compare the effect of subtypes on the 2-year event-free survival (EFS) of DLBCL patients who received RCHOP therapy. Methods: This research is a retrospective cohort study sourced from patient medical record data RSCM who registered from January 2014-March 2021. We collected demographic data, clinical examination results, hematology parameter, LDH, radiological examinations and events for 2 years. Survival analysis was performed using the Kaplan-Meier curve, cox-regression test was performed to assess the hazard ratio (HR). Nominal variables  compared using the Chi-Square test, while numerical variables analyzed using independent T-Test. Results: Our study found 108 DLBCL patients with 33 GCB subtype patients (30.6%), median age 53 years (range 18—88 years), 60 (55.6%) were at stage I or II, and 89 (82%) patients had extranodal lesions 0-1. Event free survival in the GCB subtype was 54.5% and in the non GCB subtype group was 42.7%. The mean EFS for the GCB subtype was 19.6 months (95% CI, 17.38-21.82) and for the non-GCB subtype 18.6 months (95% CI, 17.21-20.01). The HR for GCB subtype was 0.749 (95% CI: 0.416-1.349, p=0.336). Conclusion: DLBCL patients with the GCB subtype have better 2-year EFS and a longer mean EFS time compared to non-GCB. The GCB subtype protective against  event (p>0,05).