An observational study in Diffuse Large B-cell Lymphoma, sponsored by Grupo Español de Linfomas y Transplante Autólogo de Médula Ósea. Completed at 56 sites in Spain. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2016-04-18.
Sponsored by Grupo Español de Linfomas y Transplante Autólogo de Médula Ósea · Observational
The purpose of this study is to evaluate the prognostic value of clinical and biological factors in patients with refractory/relapsed Diffuse Large B-Cell Lymphoma.
The main aim of this study is to compare the prognostic value of R-IPI at diagnosis and relapse, relating it with the obtained response after second line
5,578 studies on the registry are indexed under Lymphoma; 825 are open to participants now.
This study's enrollment of 158 is above the median of 136 across 625 observational studies indexed under Lymphoma.
Browse Lymphoma studies →Grupo Español de Linfomas y Transplante Autólogo de Médula Ósea is the lead sponsor of 25 studies on the registry; 5 are open to participants now.
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Patients with refractory/relapsed diffuse large B-cell lymphoma
patients with refractory/relapsed diffuse large B-cell lymphoma
R-IPI Index (Revised International Prognostic Index)
Data will be recorded from diagnosis to second line response, an expected average of 7 months
Time frame: At diagnoses
R-IPI Index (Revised International Prognostic Index)
The IPI is based on the evaluation of 5 clinical factors: age \> 60 years Ann Arbor stage III or IV disease \> 1 extra nodal site European Cooperative Oncology Group performance status (ECOG PS) _ 2, increased serum LDH (lactate dehydrogenase) levels Revised IPI (R-IPI) evaluates the same parameters, but groups them differently to form 3 prognostic groups of patients with significantly different progression-free survival and overall survival outcomes.
Time frame: At the beginning of the 2nd line of treatment, an average of 2 years
Predictive Value of R-IPI at Diagnosis
Time frame: At diagnosis
Bcl-2 Expression
immunohistochemical reaction of cells with Bcl-2 antibody
Time frame: At diagnosis
Bcl-2 Expression
immunohistochemical reaction of cells with Bcl-2 antibody
Time frame: At the beginning of the 2nd line of treatment
Bcl-6 Expression
immunohistochemical reaction of cells with Bcl-6 antibody
Time frame: At diagnosis
Bcl-6 Expression
immunohistochemical reaction of cells with Bcl-6 antibody
Time frame: At the beginning of the second line of treatment
p-53 Expression
immunohistochemical reaction of cells with p-53 antibody
Time frame: At diagnosis
p53 Expression
immunohistochemical reaction of cells with p-53 antibody
Time frame: At the beginning of the 2nd line of treatment
Multiple Myeloma Oncogene 1 (MUM-1) Expression
immunohistochemical reaction of cells with MUM-1 antibody
Time frame: At diagnosis
MUM-1 Expression
immunohistochemical reaction of cells with MUM-1 antibody
Time frame: At the beginning of the 2nd line of treatment
Eastern Cooperative Oncology Group Performance Status (ECOG) Performance Status
ECOG=0: Fully active, able to carry on all pre-disease performance without restriction ECOG=5: Exitus
Time frame: At the beginning of the 2nd line of treatment
Ann Arbor Staging
Ann Arbor=I: Best condition Ann Arbor=IV: Worst condition
Time frame: At the beginning of the 2nd line of treatment
Response to First Line of Treatment
Complete Response (CR), Disappearance of all target lesions for at least 8 weeks. Partial response (PR): At least a 50% dicrease in the sum of the products of two measurements (the maximum diameter of a tumor and the largest diameter perpendicular to this maximum diameter) of 6 biggest individual tumors. Not increased of measure of other tumors, spleen or liver Stable Disease (SD): Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum LD since the treatment started Progressive Disease (PD): At least a 50% increase in the sum of the LD of target lesions, taking as reference the smallest sum LD recorded since the treatment started or the appearance of one or more new lesions during or at the end of the treatment.
Time frame: After first line treatment
Response to Second Line of Treatment
Complete Response (CR), Disappearance of all target lesions for at least 8 weeks. Partial response (PR): At least a 50% dicrease in the sum of the products of two measurements (the maximum diameter of a tumor and the largest diameter perpendicular to this maximum diameter) of 6 biggest individual tumors. Not increased of measure of other tumors, spleen or liver Stable Disease (SD): Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum LD since the treatment started Progressive Disease (PD): At least a 50% increase in the sum of the LD of target lesions, taking as reference the smallest sum LD recorded since the treatment started or the appearance of one or more new lesions during or at the end of the treatment.
Time frame: After second line of treatment
Relationship Between Global Response Rate to 2nd (Second) Line of Treatment and Bcl-2 Expression at Diagnosis
Global response rate was assessed using the National Cancer Institute-sponsored Working Group guidelines. Responses are: complete response, partial response, stable disease, progression and relapse
Time frame: At diagnosis
Relationship Between Global Response Rate to 2nd Line of Treatment and Bcl-6 Expression at Diagnosis
Global response rate was assessed using the National Cancer Institute-sponsored Working Group guidelines. Responses are: complete response, partial response, stable disease, progression and relapse
Time frame: At diagnosis
Relationship Between Global Response Rate to 2nd Line of Treatment and p53 Expression at Diagnosis
Global response rate was assessed using the National Cancer Institute-sponsored Working Group guidelines. Responses are: complete response, partial response, stable disease, progression and relapse
Time frame: At diagnosis
Relationship Between Global Response Rate to 2nd Line of Treatment and Multiple Myeloma Oncogene 1 (MUM1) Expression at Diagnosis
Global response rate was assessed using the National Cancer Institute-sponsored Working Group guidelines. Responses are: complete response, partial response, stable disease, progression and relapse
Time frame: At diagnosis
Recruitment was carried out between April 2009 and January 2011 in Hematology Departments of 56 Spanish Hospitals
| Milestone | Refractory/Relapsed LDCBG (Diffuse Large-B-cell Lymphoma) |
|---|---|
| Started | 158 |
| Completed | 146 |
| Not completed | 12 |
| Withdrew: Protocol violation | 12 |
Data will be recorded from diagnosis to second line response, an expected average of 7 months
| percentage of participants | Refractory/Relapsed LDCBG |
|---|---|
| Very good prognosis (0) | 3.4 |
| Good prognosis (1,2) | 32.2 |
| Poor prognosis (3,4,5) | 64.4 |
immunohistochemical reaction of cells with Bcl-2 antibody
| percentage of participants | Refractory/Relapsed LDCBG |
|---|---|
| Positive | 54.1 |
| Negative | 8.9 |
| Not available | 37.0 |
immunohistochemical reaction of cells with Bcl-2 antibody
| participants | Refractory/Relapsed LDCBG |
|---|---|
| Positive | 30 |
| Negative | 5 |
| Not Available | 111 |
immunohistochemical reaction of cells with Bcl-6 antibody
| participants | Refractory/Relapsed LDCBG |
|---|---|
| Positive | 63 |
| Negative | 20 |
| Not available | 63 |
immunohistochemical reaction of cells with Bcl-6 antibody
| percentage of participants | Refractory/Relapsed LDCBG |
|---|---|
| Positive | 14.4 |
| Negative | 7.5 |
| Not available | 78.1 |
The IPI is based on the evaluation of 5 clinical factors: age \> 60 years Ann Arbor stage III or IV disease \> 1 extra nodal site European Cooperative Oncology Group performance status (ECOG PS) _ 2, increased serum LDH (lactate dehydrogenase) levels Revised IPI (R-IPI) evaluates the same parameters, but groups them differently to form 3 prognostic groups of patients with significantly different progression-free survival and overall survival outcomes.
| percentage of patients | Refractory/Relapsed LDCBG |
|---|---|
| Very good prognosis (0) | 9.6 |
| Good prognosis (1,2) | 47.3 |
| Poor prognosis (3,4,5) | 43.2 |
immunohistochemical reaction of cells with p-53 antibody
| percentage of participants | Refractory/Relapsed LDCBG |
|---|---|
| Positive | 12.3 |
| Negative | 10.3 |
| Not available | 77.4 |
immunohistochemical reaction of cells with p-53 antibody
| percentage of participants | Refractory/Relapsed LDCBG |
|---|---|
| Positive | 5.5 |
| Negative | 4.8 |
| Not available | 89.7 |
immunohistochemical reaction of cells with MUM-1 antibody
| percentage of participants | Refractory/Relapsed LDCBG |
|---|---|
| Positive | 16.4 |
| Negative | 10.3 |
| Not available | 73.3 |
immunohistochemical reaction of cells with MUM-1 antibody
| percentage of participants | Refractory/Relapsed LDCBG |
|---|---|
| Positive | 5.5 |
| Negative | 5.5 |
| Not available | 89.0 |
ECOG=0: Fully active, able to carry on all pre-disease performance without restriction ECOG=5: Exitus
| participants | Refractory/Relapsed LDCBG |
|---|---|
| ECOG 0 | 56 |
| ECOG 1 | 54 |
| ECOG 2 | 22 |
| ECOG 3 | 12 |
| ECOG 4 | 2 |
Ann Arbor=I: Best condition Ann Arbor=IV: Worst condition
| percentage of patients | Refractory/Relapsed LDCBG |
|---|---|
| I | 12.3 |
| II | 21.9 |
| III | 19.9 |
| IV | 45.9 |
Complete Response (CR), Disappearance of all target lesions for at least 8 weeks. Partial response (PR): At least a 50% dicrease in the sum of the products of two measurements (the maximum diameter of a tumor and the largest diameter perpendicular to this maximum diameter) of 6 biggest individual tumors. Not increased of measure of other tumors, spleen or liver Stable Disease (SD): Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum LD since the treatment started Progressive Disease (PD): At least a 50% increase in the sum of the LD of target lesions, taking as reference the smallest sum LD recorded since the treatment started or the appearance of one or more new lesions during or at the end of the treatment.
| participants | Refractory/Relapsed LDCBG |
|---|---|
| Complete response | 58 |
| Uncertain complete response | 5 |
| Partial response | 52 |
| Stable disease | 10 |
| Progressive disease | 21 |
Complete Response (CR), Disappearance of all target lesions for at least 8 weeks. Partial response (PR): At least a 50% dicrease in the sum of the products of two measurements (the maximum diameter of a tumor and the largest diameter perpendicular to this maximum diameter) of 6 biggest individual tumors. Not increased of measure of other tumors, spleen or liver Stable Disease (SD): Neither sufficient shrinkage to qualify for PR nor sufficient increase to qualify for PD, taking as reference the smallest sum LD since the treatment started Progressive Disease (PD): At least a 50% increase in the sum of the LD of target lesions, taking as reference the smallest sum LD recorded since the treatment started or the appearance of one or more new lesions during or at the end of the treatment.
| participants | Refractory/Relapsed LDCBG |
|---|---|
| Complete response | 46 |
| Uncertain complete response | 15 |
| Partial response | 27 |
| Stable disease | 9 |
| Progressive disease | 38 |
| Not evaluated | 10 |
| participants | Refractory/Relapsed LDCBG |
|---|---|
| Global response to 2nd line + very good prognos | 4 |
| No global response to 2nd line + very good prognos | 1 |
| Global response to 2nd line + good prognosis | 28 |
| No global response to 2nd line + good prognosis | 19 |
| Global response to 2nd line + poor prognosis | 56 |
| No global response to 2nd line + poor prognosis | 37 |
Global response rate was assessed using the National Cancer Institute-sponsored Working Group guidelines. Responses are: complete response, partial response, stable disease, progression and relapse
| participants | Refractory/Relapsed LDCBG |
|---|---|
| Global response to 2nd line + Bcl-2 + | 50 |
| Global response to 2nd line + Bcl-2 - | 8 |
| No global response to 2nd line + Bcl-2 + | 28 |
| No global response to 2nd line + Bcl-2 - | 5 |
| Global response to 2nd line +Bcl-2 ND | 30 |
| No global response to 2nd line + Bcl-2 ND | 24 |
Global response rate was assessed using the National Cancer Institute-sponsored Working Group guidelines. Responses are: complete response, partial response, stable disease, progression and relapse
| participants | Refractory/Relapsed LDCBG |
|---|---|
| Global response to 2nd line + Bcl-6 + | 34 |
| Global response to 2nd line + Bcl-6 - | 14 |
| Global response to 2nd line + Blc-6 ND | 40 |
| No global response to 2nd line + Bcl-6 + | 28 |
| No global response to 2nd line + Bcl-6 - | 6 |
| No global response to 2nd line + Bcl-6 ND | 23 |
Global response rate was assessed using the National Cancer Institute-sponsored Working Group guidelines. Responses are: complete response, partial response, stable disease, progression and relapse
| participants | Refractory/Relapsed LDCBG |
|---|---|
| Global response to 2nd line + p53+ | 13 |
| Global response to 2nd line + p53- | 8 |
| No global response to 2nd line + p53+ | 5 |
| No global response to 2nd line + p53- | 6 |
| Global response to 2nd line + p53 ND | 67 |
| Global response to 2nd line + p53 - ND | 46 |
Global response rate was assessed using the National Cancer Institute-sponsored Working Group guidelines. Responses are: complete response, partial response, stable disease, progression and relapse
| participants | Refractory/Relapsed LDCBG |
|---|---|
| Global response to 2nd line + MUM1 + | 17 |
| Global response to 2nd line + MUM1 - | 6 |
| No global response to 2nd line + MUM1 + | 7 |
| No global response to 2nd line + MUM1 - | 8 |
| Global response to 2nd line + MUM1 ND | 65 |
| No global response to 2nd line + MUM1 ND | 42 |
Global response rate was assessed using the National Cancer Institute-sponsored Working Group guidelines. Responses are: complete response, partial response, stable disease, progression and relapse
| participants | Refractory/Relapsed LDCBG |
|---|---|
| Global response to 2nd line + lymphocyte <1 | 40 |
| Global response to 2nd line + lymphocyte >=1 | 47 |
| No global response to 2nd line + lymphocyte <1 | 35 |
| No global response to 2nd line + lymphocyte >=1 | 20 |
Global response rate was assessed using the National Cancer Institute-sponsored Working Group guidelines. Responses are: complete response, partial response, stable disease, progression and relapse
| participants | Refractory/Relapsed LDCBG |
|---|---|
| Global response to 2nd line + ratio <=2.6 | 46 |
| Global response to 2nd line + ratio >2.6 | 40 |
| No global response to 2nd line + ratio <=2.6 | 37 |
| No global response to 2nd line + ratio >2.6 | 18 |
Global response rate was assessed using the National Cancer Institute-sponsored Working Group guidelines. Responses are: complete response, partial response, stable disease, progression and relapse
| mg/100ml | Refractory/Relapsed LDCBG |
|---|---|
| Global response to 2nd line | 2.47 ± 1.51 |
| No global response to 2nd line | 2.41 ± 1.51 |
Non-serious events are listed at a 5% frequency threshold.
| Group | Deaths | Serious | Other |
|---|---|---|---|
| Refractory/Relapsed LDCBG | — | 18/146 (12.3%) | 44/146 (30.1%) |
| Event | Refractory/Relapsed LDCBG |
|---|---|
| NeutropeniaBlood and lymphatic system disorders | 7/146 |
| LeucopeniaBlood and lymphatic system disorders | 6/146 |
| TrombocitopeniaBlood and lymphatic system disorders | 4/146 |
| AnemiaBlood and lymphatic system disorders | 1/146 |
| Event | Refractory/Relapsed LDCBG |
|---|---|
| Gastrointestinal symptomsGastrointestinal disorders | 18/146 |
| FatigueGeneral disorders | 17/146 |
| AnorexiaMetabolism and nutrition disorders | 9/146 |
12 patients were not included in the data analysis for not fulfilling selection criteria
| Age, Continuous(years) | Refractory/Relapsed LDCBG |
|---|---|
| Mean | 58.4 ± 14.1 |
| Sex: Female, Male(Participants) | Refractory/Relapsed LDCBG |
|---|---|
| Female | 68 |
| Male | 78 |
| Ann Arbor Staging(participants) | Refractory/Relapsed LDCBG |
|---|---|
| I | 6 |
| II | 20 |
| III | 37 |
| IV | 83 |
| ECOG Performance Status (Eastern Cooperative Oncology Group Performance Status)(participants) | Refractory/Relapsed LDCBG |
|---|---|
| ECOG 0 | 48 |
| ECOG 1 | 55 |
| ECOG 2 | 25 |
| ECOG 3 | 15 |
| ECOG 4 | 3 |
This study is completed, as verified in Mar 2016. You cannot join it, but the record below documents what was studied.
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