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Type 2 diabetes leads to poorer outcomes in diffuse large B-cell lymphoma

14 Mar 2020

The presence of type 2 diabetes mellitus (T2DM) worsens survival in patients with diffuse large B-cell lymphoma (DLBCL), a recent study has found.

Researchers enrolled 469 DLBCL patients (median age at diagnosis, 76 years; 52.2 percent female) who were being treated with R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone). The primary outcome was overall survival (OS), while secondary outcomes included progression-free survival (PFS), the incidence of relapse or progression, and the nonrelapse/progression mortality.

The 5-year OS estimate was 79 percent for participants who did not have T2DM, which was significantly higher than the 64-percent rate in those who did have T2DM (p=0.01). Neither subgroup reached the median OS.

Similarly, heart failure had a significant impact on OS, reducing 5-year estimates to 49 percent in patients with the condition, as opposed to 79 percent in those without (p=0.002).

In terms of secondary outcomes, T2DM likewise significantly cut 5-year PFS rates in DLBCL patients (50.6 percent vs 62.6 percent; p=0.036).

These were further confirmed in multivariate proportional hazards regression analysis, in which T2DM (hazard ratio [HR], 1.9, 95 percent confidence interval [CI], 1.2–3.2; p=0.01) and pre-existing heart failure (HR, 2.5, 95 percent CI, 1.4–4.4; p=0.002) emerged as significant prognostic factors for OS. Similarly, T2DM (HR, 1.6, 95 percent CI, 1.03–2.4; p=0.036) and heart failure (HR, 1.9, 95 percent CI, 1.1–3.1; p=0.014) had the same effect on PFS.

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At the Novartis-sponsored VERIFY Soft Launch held at Le Meridien, Kuala Lumpur, two distinguished speakers spoke on the latest updates in glucose-lowering therapy and the benefit of early treatment intensification using combination therapy (ie, vildagliptin/metformin) in the management of T2DM.