Outcomes of gastrointestinal bleeding events after first-line chemotherapy in gastrointestinal-diffuse large B-cell lymphoma: a propensity-score matched analysis.
5 affiliations
- 1Department of Hematology and Oncology, Wenzhou People's Hospital, Wenzhou, 325000, China.
- 2Department of Hematology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China.
- 3Department of Hematology, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, 200065, China. [email protected].
- 4Clinical Research Ward of Cancer Center, Shanghai Tongji Hospital, Tongji University School of Medicine, Shanghai, 200065, China. [email protected].
- 5Department of Hematology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, China. [email protected].
Abstract
Gastrointestinal bleeding (GIB) is a life-threatening complication of first-line chemotherapy in gastrointestinal diffuse large B-cell lymphoma (GI-DLBCL), yet its prognostic significance remains poorly defined. This propensity score-matched study (1:2) included 79 patients with GI-DLBCL, comparing 9 with post-chemotherapy GIB to controls without GIB. Matching was based on gender, clinical stage, Hans classification, and Eastern Cooperative Oncology Group (ECOG) performance status. Patients with GIB had worse overall survival (OS, P = 0.006) and progression-free survival(PFS, P = 0.011), with markedly lower complete (11.11% vs. 66.67%, P = 0.013) and objective (66.67% vs. 100.00%, P = 0.029) response rates. Higher baseline PET-CT parameters including gastrointestinal-metabolic tumor volume (GI-MTV, P = 0.002) and gastrointestinal-total lesion glycolysis (GI-TLG, P = 0.004) indicated GIB occurrence. In the survival analysis, high ECOG (P = 0.032), whole-body metabolic tumor volume (Wb-MTV, P = 0.012), and total lesion glycolysis (Wb-TLG, P = 0.038) might be associated with poor OS, while high ECOG (P = 0.008) and international prognostic index (IPI, P =0.027) were associated with poor PFS. GIB was successfully managed with conservative medical therapy in the majority of cases (77.78%), with the remainder (22.22%) requiring endoscopic hemostasis. Post-chemotherapy GIB in GI-DLBCL is associated with a poor prognosis, particularly in patients with elevated baseline PET/CT metabolic parameters indicative of high tumor burden.
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BibTeX
@article{li2026outcomes,
title = {{Outcomes of gastrointestinal bleeding events after first-line chemotherapy in gastrointestinal-diffuse large B-cell lymphoma: a propensity-score matched analysis.}},
author = {Hui Li and Yue Shen and Suzhen Jia and Fanhuan Xu and Bin Xue and Haige Ye},
journal = {Annals of hematology},
year = {2026},
month = sep,
doi = {10.1007/s00277-026-07272-x},
url = {https://europepmc.org/article/MED/42911419},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Outcomes of gastrointestinal bleeding events after first-line chemotherapy in gastrointestinal-diffuse large B-cell lymphoma: a propensity-score matched analysis.
AU - Hui Li
AU - Yue Shen
AU - Suzhen Jia
AU - Fanhuan Xu
AU - Bin Xue
AU - Haige Ye
PY - 2026
DA - 2026/09/01
JO - Annals of hematology
DO - 10.1007/s00277-026-07272-x
UR - https://europepmc.org/article/MED/42911419
AB - Gastrointestinal bleeding (GIB) is a life-threatening complication of first-line chemotherapy in gastrointestinal diffuse large B-cell lymphoma (GI-DLBCL), yet its prognostic significance remains poorly defined. This propensity score-matched study (1:2) included 79 patients with GI-DLBCL, comparing 9 with post-chemotherapy GIB to controls without GIB. Matching was based on gender, clinical stage, Hans classification, and Eastern Cooperative Oncology Group (ECOG) performance status. Patients with GIB had worse overall survival (OS, P = 0.006) and progression-free survival(PFS, P = 0.011), with markedly lower complete (11.11% vs. 66.67%, P = 0.013) and objective (66.67% vs. 100.00%, P = 0.029) response rates. Higher baseline PET-CT parameters including gastrointestinal-metabolic tumor volume (GI-MTV, P = 0.002) and gastrointestinal-total lesion glycolysis (GI-TLG, P = 0.004) indicated GIB occurrence. In the survival analysis, high ECOG (P = 0.032), whole-body metabolic tumor volume (Wb-MTV, P = 0.012), and total lesion glycolysis (Wb-TLG, P = 0.038) might be associated with poor OS, while high ECOG (P = 0.008) and international prognostic index (IPI, P =0.027) were associated with poor PFS. GIB was successfully managed with conservative medical therapy in the majority of cases (77.78%), with the remainder (22.22%) requiring endoscopic hemostasis. Post-chemotherapy GIB in GI-DLBCL is associated with a poor prognosis, particularly in patients with elevated baseline PET/CT metabolic parameters indicative of high tumor burden.
SN - 0939-5555
SN - 1432-0584
ER -