Prognostic relevance of pretreatment quality of life in diffuse large B-cell lymphoma patients treated with rituximab-CHOP: Results from a prospective cohort study

The self-reported quality of life (QoL) has been used as an index of general health status. Thus, we evaluated the significance of pretreatment QoL in predicting survival outcome of patients with diffuse large B cell lymphoma (DLBCL). Two hundred sixty-three patients treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP) were enrolled to this prospective cohort study, and their QoL was evaluated. The pretreatment QoL was significantly associated with increased serum lactate dehydrogenase, extranodal involvement, and stage III/IV. Patients scoring poorly on the global health and function scale and high on the symptom/sign scale completed treatment at a significantly lower rate than patients with good scale. The treatment-related mortality was also more frequent in patients with poor QoL. The univariate analysis showed a prognostic relevance of pretreatment QoL, so the poor QoL group showed a worse survival outcome than the good QoL group. This pretreatment QoL also independently predicted overall survival in the multivariate analysis. Thus, the pretreatment assessment of QoL may be a valid prognostic marker for DLBCL patients treated with R-CHOP.