Risk factors associated with mortality from diagnosis of PBL
. | No. of patients . | Follow-up (y) . | No. of deaths . | Mortality rate (per 100 py) . | Univariate . | Multivariate . | ||||
---|---|---|---|---|---|---|---|---|---|---|
SHR . | 95% CI . | P value . | SHR . | 95% CI . | P value . | |||||
Total | 281 | 707.3 | 167 | 23.6 | ||||||
Age at diagnosis (y) | .001 | |||||||||
≤40 | 47 | 134.5 | 26 | 19.3 | 1 | |||||
41-65 | 151 | 415.5 | 83 | 20.0 | 0.86 | (0.54-1.38) | .537 | |||
>65 | 83 | 157.3 | 58 | 36.9 | 1.78 | (1.07-2.98) | .028 | |||
Sex | ||||||||||
Male | 199 | 548.1 | 109 | 19.9 | 1 | |||||
Female | 82 | 159.2 | 58 | 36.4 | 1.45 | (1.05-2.01) | .024 | |||
Year of diagnosis | .832 | |||||||||
≤2010 | 83 | 334.1 | 59 | 17.7 | 1 | |||||
2011-2015 | 99 | 261.7 | 60 | 22.9 | 1.04 | (0.71-1.53) | .822 | |||
2016-2020 | 99 | 111.5 | 48 | 43.0 | 1.14 | (0.74-1.76) | .547 | |||
Stage | <.001 | <.001 | ||||||||
I | 68 | 243.2 | 22 | 9.0 | 1 | 1 | ||||
II | 45 | 153.5 | 23 | 15.0 | 1.44 | (0.81-2.55) | .217 | 1.45 | (0.79-2.68) | .233 |
III | 17 | 54.2 | 13 | 24.0 | 2.87 | (1.45-5.69) | .003 | 4.11 | (2.04-8.28) | <.001 |
IV | 143 | 242.3 | 102 | 42.1 | 3.17 | (1.97-5.11) | <.001 | 2.68 | (1.62-4.44) | <.001 |
Not reported | 8 | 14.2 | 7 | 49.4 | ||||||
HIV status | .470 | |||||||||
Positive | 99 | 303.8 | 54 | 17.8 | 1 | |||||
Negative | 160 | 386.0 | 92 | 23.8 | 1.16 | (0.77-1.75) | .470 | |||
Not tested/unknown | 22 | 17.5 | 21 | 120.3 | ||||||
MYC rearrangement | .869 | |||||||||
Yes | 52 | 119.7 | 28 | 23.4 | 1 | |||||
No | 41 | 109.6 | 23 | 21.0 | 0.95 | (0.51-1.76) | .869 | |||
Not tested/unknown | 188 | 478.0 | 116 | 24.3 | ||||||
EBV status | .033 | |||||||||
Positive | 160 | 428.0 | 80 | 18.7 | 1 | 1 | ||||
Negative | 73 | 174.7 | 50 | 28.6 | 1.52 | (1.03-2.22) | .033 | 1.57 | (1.03-2.39) | .037 |
Not tested/unknown | 48 | 104.6 | 37 | 35.4 | ||||||
CD20+ | .313 | |||||||||
Yes | 26 | 60.5 | 17 | 28.1 | 1 | |||||
Weak | 11 | 20.5 | 8 | 39.1 | 1.64 | (0.74-3.60) | .220 | |||
No | 217 | 544.2 | 124 | 22.8 | 0.97 | (0.60-1.56) | .889 | |||
Not tested/unknown | 27 | 82.1 | 18 | 21.9 | ||||||
CD19+ | .214 | |||||||||
Yes | 10 | 20.3 | 4 | 19.7 | 1 | |||||
No | 33 | 67.6 | 20 | 29.6 | 2.09 | (0.65-6.70) | .214 | |||
Not tested/unknown | 238 | 619.4 | 143 | 23.1 | ||||||
CD30+ | .601 | |||||||||
Yes | 44 | 103.4 | 29 | 28.0 | 1 | |||||
No | 116 | 318.0 | 61 | 19.2 | 0.88 | (0.54-1.42) | .601 | |||
Not tested/unknown | 121 | 285.9 | 77 | 26.9 | ||||||
BM involvement | <.001 | |||||||||
Yes | 51 | 71.7 | 39 | 54.4 | 1 | 1 | ||||
No | 169 | 553.7 | 83 | 15.0 | 0.42 | (0.28-0.64) | <.001 | 0.52 | (0.32-0.83) | .006 |
Not tested/unknown | 61 | 82.0 | 45 | 54.9 | ||||||
CNS involvement | .009 | |||||||||
Yes | 13 | 13.4 | 11 | 82.3 | 1 | |||||
No | 183 | 504.9 | 97 | 19.2 | 0.37 | (0.18-0.78) | .009 | |||
Not tested/unknown | 85 | 189.0 | 59 | 31.2 | ||||||
Location of primary tumor | <.001 | |||||||||
Oropharynx/nasopharynx/orbit | 79 | 292.6 | 27 | 9.2 | 1 | |||||
Other site | 181 | 356.2 | 128 | 35.9 | 2.60 | (1.72-3.94) | <.001 | |||
Not reported/unknown | 21 | 58.5 | 12 | 20.5 | ||||||
LDH level | <.001 | |||||||||
Elevated | 155 | 365.2 | 102 | 27.9 | 1 | |||||
Not elevated | 87 | 250.9 | 34 | 13.6 | 0.49 | (0.33-0.73) | <.001 | |||
Not tested/unknown | 39 | 91.2 | 31 | 34.0 | ||||||
ECOG performance status | <.001 | |||||||||
≤1 | 182 | 583.8 | 80 | 13.7 | 1 | 1 | ||||
>1 | 84 | 101.4 | 74 | 73.0 | 3.79 | (2.58-5.59) | <.001 | 2.28 | (1.50-3.48) | <.001 |
Not reported | 15 | 22.1 | 13 | 58.9 | ||||||
Frontline treatment | <.001 | <.001 | ||||||||
High intensity | 75 | 229.4 | 34 | 14.8 | 1 | 1 | ||||
Standard intensity | 159 | 433.5 | 90 | 20.8 | 1.06 | (0.71-1.59) | .773 | 1.40 | (0.86-2.28) | .173 |
Other | 43 | 44.4 | 39 | 87.8 | 4.43 | (2.60-7.56) | <.001 | 6.52 | (3.68-11.55) | <.001 |
Not reported | 4 | 0.0 | 4 | 14 610.0 | ||||||
Rituximab | ||||||||||
Yes | 45 | 111.4 | 27 | 24.2 | 1 | |||||
No | 236 | 595.9 | 140 | 23.5 | 1.1 | (0.72-1.67) | .669 | |||
PI-containing regimen | .195 | |||||||||
Yes | 33 | 62.9 | 12 | 19.1 | 1 | |||||
No | 205 | 600.5 | 116 | 19.3 | 1.52 | (0.81-2.88) | .195 | |||
Not reported | 43 | 44.0 | 39 | 88.7 | ||||||
ASCT in first line | ||||||||||
Yes | 13 | 59.0 | 5 | 8.5 | 1 | |||||
No | 268 | 648.3 | 162 | 25.0 | 2.02 | (0.97-4.23) | .061 | |||
IPI | <.001 | |||||||||
Low risk | 76 | 272.7 | 19 | 7.0 | 1 | |||||
Low-intermediate risk | 49 | 153.3 | 27 | 17.6 | 2.34 | (1.35-4.05) | .002 | |||
High-intermediate risk | 68 | 121.2 | 48 | 39.6 | 3.90 | (2.28-6.69) | <.001 | |||
High risk | 36 | 40.9 | 32 | 78.1 | 8.08 | (4.43-14.76) | <.001 | |||
Not reported | 52 | 119.2 | 41 | 34.4 |
. | No. of patients . | Follow-up (y) . | No. of deaths . | Mortality rate (per 100 py) . | Univariate . | Multivariate . | ||||
---|---|---|---|---|---|---|---|---|---|---|
SHR . | 95% CI . | P value . | SHR . | 95% CI . | P value . | |||||
Total | 281 | 707.3 | 167 | 23.6 | ||||||
Age at diagnosis (y) | .001 | |||||||||
≤40 | 47 | 134.5 | 26 | 19.3 | 1 | |||||
41-65 | 151 | 415.5 | 83 | 20.0 | 0.86 | (0.54-1.38) | .537 | |||
>65 | 83 | 157.3 | 58 | 36.9 | 1.78 | (1.07-2.98) | .028 | |||
Sex | ||||||||||
Male | 199 | 548.1 | 109 | 19.9 | 1 | |||||
Female | 82 | 159.2 | 58 | 36.4 | 1.45 | (1.05-2.01) | .024 | |||
Year of diagnosis | .832 | |||||||||
≤2010 | 83 | 334.1 | 59 | 17.7 | 1 | |||||
2011-2015 | 99 | 261.7 | 60 | 22.9 | 1.04 | (0.71-1.53) | .822 | |||
2016-2020 | 99 | 111.5 | 48 | 43.0 | 1.14 | (0.74-1.76) | .547 | |||
Stage | <.001 | <.001 | ||||||||
I | 68 | 243.2 | 22 | 9.0 | 1 | 1 | ||||
II | 45 | 153.5 | 23 | 15.0 | 1.44 | (0.81-2.55) | .217 | 1.45 | (0.79-2.68) | .233 |
III | 17 | 54.2 | 13 | 24.0 | 2.87 | (1.45-5.69) | .003 | 4.11 | (2.04-8.28) | <.001 |
IV | 143 | 242.3 | 102 | 42.1 | 3.17 | (1.97-5.11) | <.001 | 2.68 | (1.62-4.44) | <.001 |
Not reported | 8 | 14.2 | 7 | 49.4 | ||||||
HIV status | .470 | |||||||||
Positive | 99 | 303.8 | 54 | 17.8 | 1 | |||||
Negative | 160 | 386.0 | 92 | 23.8 | 1.16 | (0.77-1.75) | .470 | |||
Not tested/unknown | 22 | 17.5 | 21 | 120.3 | ||||||
MYC rearrangement | .869 | |||||||||
Yes | 52 | 119.7 | 28 | 23.4 | 1 | |||||
No | 41 | 109.6 | 23 | 21.0 | 0.95 | (0.51-1.76) | .869 | |||
Not tested/unknown | 188 | 478.0 | 116 | 24.3 | ||||||
EBV status | .033 | |||||||||
Positive | 160 | 428.0 | 80 | 18.7 | 1 | 1 | ||||
Negative | 73 | 174.7 | 50 | 28.6 | 1.52 | (1.03-2.22) | .033 | 1.57 | (1.03-2.39) | .037 |
Not tested/unknown | 48 | 104.6 | 37 | 35.4 | ||||||
CD20+ | .313 | |||||||||
Yes | 26 | 60.5 | 17 | 28.1 | 1 | |||||
Weak | 11 | 20.5 | 8 | 39.1 | 1.64 | (0.74-3.60) | .220 | |||
No | 217 | 544.2 | 124 | 22.8 | 0.97 | (0.60-1.56) | .889 | |||
Not tested/unknown | 27 | 82.1 | 18 | 21.9 | ||||||
CD19+ | .214 | |||||||||
Yes | 10 | 20.3 | 4 | 19.7 | 1 | |||||
No | 33 | 67.6 | 20 | 29.6 | 2.09 | (0.65-6.70) | .214 | |||
Not tested/unknown | 238 | 619.4 | 143 | 23.1 | ||||||
CD30+ | .601 | |||||||||
Yes | 44 | 103.4 | 29 | 28.0 | 1 | |||||
No | 116 | 318.0 | 61 | 19.2 | 0.88 | (0.54-1.42) | .601 | |||
Not tested/unknown | 121 | 285.9 | 77 | 26.9 | ||||||
BM involvement | <.001 | |||||||||
Yes | 51 | 71.7 | 39 | 54.4 | 1 | 1 | ||||
No | 169 | 553.7 | 83 | 15.0 | 0.42 | (0.28-0.64) | <.001 | 0.52 | (0.32-0.83) | .006 |
Not tested/unknown | 61 | 82.0 | 45 | 54.9 | ||||||
CNS involvement | .009 | |||||||||
Yes | 13 | 13.4 | 11 | 82.3 | 1 | |||||
No | 183 | 504.9 | 97 | 19.2 | 0.37 | (0.18-0.78) | .009 | |||
Not tested/unknown | 85 | 189.0 | 59 | 31.2 | ||||||
Location of primary tumor | <.001 | |||||||||
Oropharynx/nasopharynx/orbit | 79 | 292.6 | 27 | 9.2 | 1 | |||||
Other site | 181 | 356.2 | 128 | 35.9 | 2.60 | (1.72-3.94) | <.001 | |||
Not reported/unknown | 21 | 58.5 | 12 | 20.5 | ||||||
LDH level | <.001 | |||||||||
Elevated | 155 | 365.2 | 102 | 27.9 | 1 | |||||
Not elevated | 87 | 250.9 | 34 | 13.6 | 0.49 | (0.33-0.73) | <.001 | |||
Not tested/unknown | 39 | 91.2 | 31 | 34.0 | ||||||
ECOG performance status | <.001 | |||||||||
≤1 | 182 | 583.8 | 80 | 13.7 | 1 | 1 | ||||
>1 | 84 | 101.4 | 74 | 73.0 | 3.79 | (2.58-5.59) | <.001 | 2.28 | (1.50-3.48) | <.001 |
Not reported | 15 | 22.1 | 13 | 58.9 | ||||||
Frontline treatment | <.001 | <.001 | ||||||||
High intensity | 75 | 229.4 | 34 | 14.8 | 1 | 1 | ||||
Standard intensity | 159 | 433.5 | 90 | 20.8 | 1.06 | (0.71-1.59) | .773 | 1.40 | (0.86-2.28) | .173 |
Other | 43 | 44.4 | 39 | 87.8 | 4.43 | (2.60-7.56) | <.001 | 6.52 | (3.68-11.55) | <.001 |
Not reported | 4 | 0.0 | 4 | 14 610.0 | ||||||
Rituximab | ||||||||||
Yes | 45 | 111.4 | 27 | 24.2 | 1 | |||||
No | 236 | 595.9 | 140 | 23.5 | 1.1 | (0.72-1.67) | .669 | |||
PI-containing regimen | .195 | |||||||||
Yes | 33 | 62.9 | 12 | 19.1 | 1 | |||||
No | 205 | 600.5 | 116 | 19.3 | 1.52 | (0.81-2.88) | .195 | |||
Not reported | 43 | 44.0 | 39 | 88.7 | ||||||
ASCT in first line | ||||||||||
Yes | 13 | 59.0 | 5 | 8.5 | 1 | |||||
No | 268 | 648.3 | 162 | 25.0 | 2.02 | (0.97-4.23) | .061 | |||
IPI | <.001 | |||||||||
Low risk | 76 | 272.7 | 19 | 7.0 | 1 | |||||
Low-intermediate risk | 49 | 153.3 | 27 | 17.6 | 2.34 | (1.35-4.05) | .002 | |||
High-intermediate risk | 68 | 121.2 | 48 | 39.6 | 3.90 | (2.28-6.69) | <.001 | |||
High risk | 36 | 40.9 | 32 | 78.1 | 8.08 | (4.43-14.76) | <.001 | |||
Not reported | 52 | 119.2 | 41 | 34.4 |
Global P values were test for heterogeneity, excluding not reported/unknown values. All analyses were adjusted for site.
Risk factors that were found to be significant in the univariate model at P < .10 were included in the multivariate model. Results of those risk factors found to be significant in the multivariate model are shown.
LDH, lactate dehydrogenase; py, person years.
Values highlighted in bold represent significant covariates in the final multivariate model.