| Autor: |
Raheel Iftikhar, Usman Ahmad, Ghulam Haider, Humera Mahmood, Maryam Khan, Misbah Masood, Nida Anwar, Qamar Javed, Nadia Sajid, Rija Tariq, Sana Mehmod, Javeria Haider, Nargis Aalam Abro, Shanzah Shahbaz, Abbas Khokhar, Zeeshan Ahmed Khan, Hassan Pervez, Munira Moosajee, Zeba Aziz |
| Jazyk: |
angličtina |
| Rok vydání: |
2024 |
| Předmět: |
|
| Zdroj: |
JCO Global Oncology, Vol , Iss 10 (2024) |
| Druh dokumentu: |
article |
| ISSN: |
2687-8941 |
| DOI: |
10.1200/GO.23.00386 |
| Popis: |
PURPOSETo highlight challenges and cancer care disparities in patients of diffuse large B-cell lymphoma management in resource-constrained settings.MATERIALS AND METHODSThis multicenter retrospective study included 738 patients from 12 public and private sector hematology-oncology centers across Pakistan. Patients were divided into limited-resource and enhanced-resource settings as per national diffuse large B-cell lymphoma (DLBCL) guidelines.RESULTSThe median age at diagnosis was 47 years (range, 14-89). Male:female ratio was 2.5:1. Majority of the patients (69.3%) were treated in limited-resource settings. Computed tomography was used as a staging modality in 442 (60%) patients. Limited-stage DLBCL was present in 13.5% of patients, while 86.3% had advanced-stage disease at diagnosis. First-line regimens included rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone in 56% and cyclophosphamide, doxorubicin, vincristine, prednisone in 34% of patients, while 10% of patients received palliative regimens upfront. Of evaluable data, complete remission was documented in 299 (74.4%) patients, 39 (9.8%) had partial response and 63 (13.5%) had progressive disease. Disease-free survival (DFS) and overall survival (OS) status were not available for 345 (46.8%) patients at the time of data collection. Overall study cohort had a median follow-up of 2.2 years with a median OS of 3.6 years (95% CI, 3.1 to 4.1), median DFS of 3.1 years (95% CI, 2.6 to 3.6), and a 5-year OS of 40% and DFS of 36%.CONCLUSIONPatients from low- and middle-income countries present at an earlier age and have more advanced disease. Patients were frequently lost to follow-up, and record keeping was inadequate more so in patients treated in limited-resource settings. There is a need to establish a national lymphoma registry, improve record keeping, and standardize treatments to ensure improvement in treatment outcomes. |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
|
