Clinical Characteristics and Outcome of Diffuse Large B-Cell Lymphoma: Real-World Data From Saudi Arabia

PURPOSE Diffuse large B-cell lymphoma (DLBCL) is the most common subtype of non-Hodgkin lymphoma worldwide and in Saudi Arabia. However, regional data on clinical characteristics and outcomes remain limited. METHODS This multicenter retrospective cohort study included 516 patients age ≥14 years diagnosed with DLBCL between January 2016 and December 2023 at two tertiary hospitals in Saudi Arabia. Data on demographics, disease features, treatment, and outcomes were collected. Survival analysis was performed using Kaplan-Meier and Cox regression models. RESULTS The median age at diagnosis was 60.5 years, with 53% of patients younger than 65 years. Most patients (77%) had advanced-stage disease. Rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone was the most commonly used first-line regimen, particularly in younger patients (95% v 62%). Complete remission rates were 74% in patients younger than 65 years and 66% in those 65 years and older ( P = .09). Relapse or refractory disease occurred more frequently in older patients (40% v 27%, P = .0019). Two-year progression-free survival was 78% in younger patients and 64% in older patients ( P = .004), while 2-year overall survival (OS) was 87% and 76%, respectively ( P = .001). Age, performance status, comorbidities, MYC expression, and kidney involvement were significant predictors of OS. CONCLUSION This study provides valuable real-world insight into the clinical landscape of DLBCL in Saudi Arabia. Overall outcomes are consistent with international data, although older age and comorbidities remain associated with poorer prognosis. As advanced therapies such as chimeric antigen receptor T-cell therapy and bispecific antibodies become more available, further improvements in survival are expected. These findings underscore the need for a national lymphoma registry and continued investment in research infrastructure to guide evidence-based, personalized care.