Diffuse large B-cell lymphoma: Experience from a tertiary care center in North India

Limited information is available from developing countries regarding clinico-pathological presentation of diffuse large B-cell lymphoma (DLBCL). We undertook a retrospective case record study to determine the clinicolaboratory characteristics, treatment outcomes, and prognostic factors for DLBCL and additionally analyzed percentage distribution and patient characteristics for other major subtypes of non-Hodgkin's lymphoma (NHL). DLBCL, constituting 59.3% of all NHL cases, was the predominant subtype. For DLBCL, males:females ratio was 2.7:1 and the median age at presentation was 47 years. Lymphadenopathy was present in 57% patients and B symptoms in 56.7%. A total of 49.3% of patients had Ann Arbor Stage IV disease. Significant differences were observed between favorable (international prognostic index [IPI]-0, 1, and 2) and unfavorable prognosis groups (IPI-3, 4, and 5) with regards to mean hemoglobin levels (P\0.005), platelet counts (P\0.05), serum albumin levels (P\0.05), and erythrocyte sedimentation rates (P\0.005), thereby suggesting their role as prognostic markers in our population. The median event free survival was 32 months (95% CI: 0-92 months) and the median overall survival was 47 months (95% CI: 3-100 months). Among total NHL, the earlier age of onset, male dominant sex ratio, and higher frequency of B symptoms sets apart NHL in Indian population from that in the developed countries.