Outcomes and Prognostic Factors (Figure 1, Table 2)
The median follow-up of the entire study cohort was 66months
(range:6-114 months). The 5-year EFS and OS of the cohort were 80%
(95%CI:71–89%) and 91% (95%CI: 85–97%), respectively (Figure
2&3). The 5-year EFS/OS in limited stage disease were 78% (95%CI:
65-91%)/89% (95%CI:79–99%) and in advanced stage 80% (95%CI:
68–92%) /91% (95%CI: 83–98%) respectively. Among the study cohort
of 21 patients, there were three relapses and one toxic death. Three
patients relapsed at a median of 37months (range:19-55 months) from
diagnosis, of which two expired secondary to progression of the disease
and one patient is alive in remission following salvage chemotherapy.
None of the relapsed patients in the study cohort underwent
hematopoietic stem cell transplant due to socio-economic constraints.
Among the three relapsed patients only one had partial response (PR)
post-induction.
Patients who presented late (≥3 months) from symptom onset had a
significantly poorer 5-year event free survival of 44.4±22.2% compared
to patients presenting early (<3months) 93.3±6.4% (p-0.030).
Also, there was a trend towards poorer overall survival among pB-LBL
patients presenting with osteolytic primaries compared to soft tissue
lesions (5-year OS-75±21.7% vs 90.9±8.7%; p-0.080). None of the
patients with MDD detected in the marrow baseline relapsed. Elevated
serum lactate dehydrogenase (LDH) >1 ULN at diagnosis was
associated with significantly poorer overall survival (p-0.032). Age,
gender, stage, baseline bone marrow involvement, and Post-induction
response had no bearing on survival outcomes.