Changes in dynamics of excess mortality rates and net survival after diagnosis of follicular lymphoma or diffuse large B-cell lymphoma: comparison between European population-based data (EUROCARE-5)

AbstractWe performed a national population-based study of all patients diagnosed with diffuse large B-cell lymphoma (DLBCL) in Sweden in 2007–2014 to assess treatment intent and risk of relapsed/refractory disease, including central nervous system (CNS) relapse, in the presence of competing risks. Overall, 84% of patients started treatment with curative intent (anthracycline-based) (n = 3550, median age 69 years), whereas 14% did not (n = 594, median age 84 years) (for 2% the intent was uncertain). Patients treated with curative intent had a 5-year OS of 65.3% (95% CI: 63.7–66.9). The median OS among non-curatively treated patients was 2.9 months. The 5-year cumulative incidence of relapsed/refractory disease in curative patients was 23.1% (95% CI: 21.7–24.6, n = 847). The 2-year cumulative incidence of CNS relapse was 3.0% (95% CI: 2.5–3.6, n = 118) overall, and 8.0% (95% CI: 6.0–10.6, n = 48) among patients with high CNS-IPI (4–6), when considering other relapse locations and death as competing events. The incidence of relapsed/refractory DLBCL overall and in the CNS was lower than in previous reports, still one in seven patients was not considered fit enough to start standard immunochemotherapy at diagnosis. These results are important for quantification of groups of DLBCL patients with poor prognosis requiring completely different types of interventions.

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Socioeconomic Inequalities in Treatment and Relative Survival Among Patients with Diffuse Large B-Cell Lymphoma: A Hong Kong Population-Based Study

10.21203/rs.3.rs-145982/v1 ◽

2021 ◽

Author(s):

Shing Fung Lee ◽

Andrew Evens ◽

Andrea Ng ◽

Miguel-Angel Luque-Fernandez

Keyword(s):

Hong Kong ◽

Excess Mortality ◽

Cell Lymphoma ◽

Relative Survival ◽

B Cell Lymphoma ◽

Population Based ◽

Secular Trends ◽

Low Ses ◽

Large B Cell Lymphoma ◽

Large B Cell

Abstract The influence of socioeconomic status (SES) on access to standard chemotherapy and/or monoclonal antibody therapy, and associated secular trends, relative survival, and excess mortality, among diffuse large B-cell lymphoma (DLBCL) patients is not clear. We conducted a Hong Kong population-based cohort study and identified adult patients with histologically diagnosed DLBCL between 2000 and 2018. We examined the association of SES levels with the odds and the secular trends of receipt of chemotherapy and/or rituximab. Additionally, we estimated the long-term relative survival by SES utilizing Hong Kong life tables. Among 4,017 patients with DLBCL, 2,363 (58.8%) patients received both chemotherapy and rituximab and 740 (18.4%) patients received chemotherapy alone, while 1,612 (40.1%) and 914 (22.8%) patients received no rituximab or chemotherapy, respectively. On multivariable analysis, low SES was associated with lesser use of chemotherapy (odd ratio [OR], 0.44; 95% CI 0.34–0.57) and rituximab (OR, 0.41; 95% CI, 0.32–0.52). The socioeconomic disparity for either treatment showed no secular trend of change. Additionally, patients with low SES showed increased excess mortality, with a hazard ratio of 2.34 (95% CI, 1.67–3.28). Improving survival outcomes for patients with DLBCL requires provision of best available medical care and securing access to treatment regardless of patients’ SES.

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Trends in Utilization of Intensity Modulated Radiotherapy in Diffuse Large B-cell Lymphoma in the U.S. From 2001 to 2005: A Population-based Study

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2011.06.1067 ◽

2011 ◽

Vol 81 (2) ◽

pp. S571

Author(s):

L. Ballas ◽

P. I-Wen ◽

B.A. Guadagnolo ◽

B.D. Smith ◽

T.A. Buchholz ◽

...

Keyword(s):

B Cell ◽

Cell Lymphoma ◽

Intensity Modulated Radiotherapy ◽

B Cell Lymphoma ◽

Population Based ◽

Population Based Study ◽

Intensity Modulated ◽

Large B Cell Lymphoma ◽

The U.S ◽

Large B Cell

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New nomograms based on treatment outcome and prognostic factors for patients with spinal diffuse large B-cell lymphoma: A population‐based study

10.21203/rs.2.20787/v1 ◽

2020 ◽

Author(s):

Ben Wang ◽

Lijie Chen ◽

Boda Chen ◽

Chenglong Xie ◽

Zhenxuan Shao ◽

...

Keyword(s):

Prognostic Factors ◽

B Cell ◽

Cell Lymphoma ◽

B Cell Lymphoma ◽

Treatment Method ◽

Population Based ◽

Cancer Specific Survival ◽

Internal Validation ◽

Large B Cell Lymphoma ◽

Large B Cell

Abstract Background: Spinal diffuse large B-cell lymphoma (DLBCL) was a rare and malignant tumor, while few studies researched the prognostic factors. The prognostic factors which might have impacts on spinal DLBCL was not clear. Although chemotherapy was recognized as an optimal treatment method, but the curative effect of radiotherapy and surgery were controversial. Methods: The records of patients with spinal DLBCL were selected from the SEER database from 1991 to 2016. The incidence obtained by database was analyzed by Joinpoint Regression Program. The optimal cut-off values of age and year of diagnosis were identified by X-tail program. Univariate and multivariate survival analysis were calculated to identify independent prognostic factors. Prognostic factors were included to predict the survival possibility compared with 5 years of overall (OS) and cancer-specific survival (CSS) via the new nomograms. Results: A total of 917 patients were enrolled. Age, year of diagnosis and chemotherapy were demonstrated as independent prognostic factors for CSS and OS, and primary site was another independent prognostic factor for CSS. However, radiotherapy and surgery might be ineffective in survival. All factors were included to generate the nomograms for CSS and OS. The concordance indices (C-index) for internal validation of OS and CSS prediction were 0.697 (95%CI: 0.662-0.732) and 0.709 (95%CI: 0.692- 0.727) respectively. Conclusions: Age and year of diagnosis are closely associated with the prognosis of spinal DLBCL, and chemotherapy is an ideal treatment modality. The new nomogram is a favourable tool to evaluate the survival possibility, and is benefit for the oncologist to make clinical decisions.

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