CLINICAL CHARACTERISTICS OF 11 CASES OF EZB SUBTYPE DIFFUSE LARGE B-CELL LYMPHOMA IN SPORTS AND ATHLETIC PATIENTS

Abstract

Objective: To investigate the clinical characteristics, treatment efficacy, and unique aspects of EZB subtype Diffuse Large B-Cell Lymphoma (EZB-DLBCL) among sports and athletic patients, a population with distinct physical and lifestyle attributes that may influence disease presentation and response to therapy. Method: This study conducts a retrospective analysis of 11 EZB-DLBCL sports and athletic patients treated at our institution, focusing on their clinical features, treatment modalities, and outcomes. Emphasis was placed on understanding how athletic lifestyles might affect disease characteristics and therapy effectiveness. Result: The cohort comprised a male to female ratio of 3:8 with a median age of 63 years (range 51-73), indicating a prevalence in older athletes. Most patients (10 out of 11) presented with advanced disease (stages III-IV), and a significant number (8 out of 11) had extranodal invasion, a common trait potentially influenced by their physical activities. The International Prognostic Index (IPI) scores varied, with a majority (7 out of 11) having scores ≥3, suggesting a generally poor prognosis in this subgroup. Interestingly, the proliferation marker Ki67 was ≥50% in nearly all patients (10 out of 11), reflective of the aggressive nature of EZB-DLBCL in physically active individuals. From a therapeutic standpoint, the inclusion of Chidamide in combination with CD20 monoclonal antibodies (such as R-CDOP and R-DAEPOCH) for newly diagnosed patients showed promising results: out of the evaluable patients, the complete response (CR) rate was 75%, and the disease control rate reached 100%. This suggests that such a regimen may be particularly efficacious in the initial management of EZB-DLBCL in athletic patients. Recurrent and/or refractory patients who had previously undergone multiple treatment regimens exhibited a disease control rate of 75%, highlighting the challenges and potential for targeted therapies in this context. Conclusion: EZB-DLBCL in sports and athletic patients predominantly presents at advanced stages with a high proliferation index and significant extranodal involvement, reflecting the aggressive nature of the disease in this population. The use of Chidamide in combination with other therapies appears to offer a viable treatment strategy, potentially enhancing survival and showing better outcomes in newly diagnosed cases compared to those with relapsed or refractory disease. The findings underscore the need for tailored treatment approaches that consider the unique characteristics and lifestyle factors of athletes facing this challenging lymphoma subtype.