scholarly journals Diffuse large B cell lymphoma (DLBCL) in patients older than 65 years: analysis of 3 year Real World data of practice patterns and outcomes in England

2021 ◽  
Author(s):  
L. Hounsome ◽  
T. A. Eyre ◽  
R. Ireland ◽  
A. Hodson ◽  
R. Walewska ◽  
...  
Keyword(s):  
B Cell ◽  
Cell Lymphoma ◽  
Population Analysis ◽  
B Cell Lymphoma ◽  
Cancer Registration ◽  
Real World Data ◽  
Emergency Presentation ◽  
Disease Characteristics ◽  
Large B Cell Lymphoma ◽  
Large B Cell

Abstract Background We wished to examine treatment and outcome patterns in older diffuse large B-cell lymphoma (DLBCL) patients, with a focus on the effect of route-to-diagnosis to outcome. Methods Data were extracted from Public Health England’s National Cancer Registration and Analysis Service between 2013 and 2015 included route-to-diagnosis, disease characteristics and survival for 9186 patients ≥65 years. Systemic Anti-Cancer Therapy data identified front-line regimens, cycles and doses. Results Route-to-diagnosis were emergency (34%), NHS urgent cancer pathway (rapid haemato-oncologist review <2 weeks), (29%) and standard GP referral (25%). The most common regimen was R-CHOP (n = 4392). 313 patients received R-miniCHOP (7% of R-CHOP). For all patients, 3-year overall survival (OS) for 65–79 years was 57% and for ≥80 years was 32%. Three-year OS for R-CHOP-treated patients diagnosed via emergency presentation was 54% (adjusted hazard ratio (HR) 1.63, p < 0.01) and 75% (adjusted HR 0.81, p < 0.01) on the NHS urgent cancer pathway (reference HR:1.00: GP referrals). 3-year OS was 54% for both R-miniCHOP and R-CHOP in ≥80 years. Conclusions Our comprehensive population analysis is the first to show that the NHS urgent cancer pathway is associated with a superior survival after adjusting for multiple confounders. Equivalent survival for R-CHOP and R-mini-CHOP was demonstrated in those ≥80 years.

scholarly journals Disease characteristics, patterns of care, and survival in very elderly patients with diffuse large B-cell lymphoma

Cancer ◽  
2015 ◽  
Vol 121 (11) ◽  
pp. 1800-1808 ◽  
Author(s):  
Jessica N. Williams ◽  
Ashish Rai ◽  
Joseph Lipscomb ◽  
Jean L. Koff ◽  
Loretta J. Nastoupil ◽  
...  
Keyword(s):  
Elderly Patients ◽  
B Cell ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Patterns Of Care ◽  
Very Elderly ◽  
Disease Characteristics ◽  
Large B Cell Lymphoma ◽  
Large B Cell

scholarly journals Establishment of a Nomogram for Patients with Primary Mediastinal Large B-Cell Lymphoma Based on the SEER Database and Validation of Real-World Data

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 1341-1341
Author(s):  
Hua Wang ◽  
Guanjun Chen ◽  
Bibo Fu
Keyword(s):  
Prognostic Factors ◽  
B Cell ◽  
Cell Lymphoma ◽  
External Validation ◽  
B Cell Lymphoma ◽  
Seer Database ◽  
Real World Data ◽  
Decision Curve Analysis ◽  
Large B Cell Lymphoma ◽  
Large B Cell

Abstract Background Primary mediastinal large B-cell lymphoma (PMBCL) is a rare disease with the majority of patients being rapidly progressive anterior mediastinal large tumors. Due to the rarity of PMBCL, information on the incidence, clinical features, prognostic factors and models of PMBCL is limited. The present study is one of the largest studies on the incidence and prognostic factors of PMBCL and is the first to establish a nomogram model of PMBCL and validate it with real-world data. We also compared the newly established Nomogram with the existing IPI prognostic model. We believe that our findings can help clinicians to quickly and accurately assess the predicted survival of patients and help them to perform individualized risk stratification of patients. Methods Based on data from the Surveillance, Epidemiology and End Results (SEER) database, 797 patients diagnosed with PMBCL were enrolled in this study. The 797 patients were randomly divided into training and internal validation groups in a 7:3 ratio, and 116 patients diagnosed with PMBCL were included in the external validation group based on data from the Sun Yat-sen University Cancer Center and the First Affiliated Hospital of Guangzhou Medical University. Independent prognostic factors were screened by Cox regression analysis. R-coding was used to construct nomograms predicting overall survival (OS). Discriminations and corrections of the new model were assessed using the consistency index (C-index), subject operating characteristic curves (ROC) and calibration curves, and compared with the conventional international prognostic index (IPI) using decision curve analysis (DCA) to assess its accuracy and benefit. Results From 2001 to 2016, the incidence of primary mediastinal large B-cell lymphoma showed a relatively stable increasing trend with an APC of 11.8% (95% confidence interval 8.8-14.0, P&lt;0.05), and this trend was more pronounced in the female population. Multivariate models showed that age and Ann arbor staging were significantly associated with OS, while the variable of extra-nodal invasion was included in the modeling based on clinical experience. In the training cohort, the C-index of the nomogram for OS was 0.712. the C-index for the internal and external validation cohorts was 0.667 and 0.690, respectively. The calibration curve also showed high predictive accuracy. The C-index and ROC curves of nomogram showed better results compared to IPI scores, and also yielded better net gains in decision curve analysis. Conclusion In summary, we successfully established a validated nomogram for predicting OS in patients with PMBCL, which can help clinicians to select appropriate individualized treatment for their patients. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.

VP46 German Claims Data In Rare Disease HTA: Diffuse Large B-cell Lymphoma

2019 ◽  
Vol 35 (S1) ◽  
pp. 87-87
Author(s):  
Aljoscha Neubauer ◽  
Susanne Guthoff-Hagen ◽  
Jacob Menzler ◽  
Carsten Schwenke ◽  
Markus Rueckert ◽  
...  
Keyword(s):  
B Cell ◽  
Rare Disease ◽  
Claims Data ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Real World Data ◽  
Oncological Treatment ◽  
Large B Cell Lymphoma ◽  
Sick Fund ◽  
Large B Cell

IntroductionIn rare disease areas representative data are scarce. Routine sick fund claims data provide a meaningful and reliable base for the in- and outpatient treatment landscape. This real-world data (RWE) from Germany was used to describe treatment patterns for Diffuse Large B-cell Lymphoma (DLBCL), the most frequent and aggressive non-Hodgkin lymphoma type in adults.MethodsClaims data from several sick funds of 4.8 Million insured were analyzed. Diagnosis of non-follicular Lymphoma (C83) was confirmed in 2.178 patients, DLBCL (C83.3) in 819 patients. The analysis was age- and gender-adjusted, observational period was 2014 and 2015. Treatments were analyzed for hospitalization and medication based on ATC-Code, Pharma Central Number and coded diagnoses (per ICD).ResultsMean age of DLBCL patients was 60.3 years, with two peaks at 50-54 and 70-74 years. Total costs for patients with DLBCL averaged 25.048 EUR versus 1.259 EUR in healthy insured. Charlson comorbidity index (CCI) of 4.58 indicates clinical relevance and severity. Comorbidities included several psychiatric diagnoses such as depression in every fifth patient. Mean 3.2 hospitalizations with average 31.5 hospital days were observed in DLBCL patients. Forty-seven percent of patients during observational time-frame did not receive oncological treatment, including relapsed / refractory patients. Only few patients received stem cell transplantation (2.6 percent) or radiation (3.9 percent). Most pharmacological treatments were Rituximab (RTX) + CHOP (57 percent), followed by RTX mono therapy (25 percent) or RTX in combination with Bendamustine (8 percent).ConclusionsDespite limitations in sick fund claims analyses, these provide a reasonable database for rare diseases. They allow standard treatment pathway- and longitudinal analyses. All DLBCL patients frequently required hospitalization and generated significant costs. A high unmet medical need exists for treatments other than palliative care, especially for a tolerable and effective outpatient therapy in elderly relapsed / refractory DLBCL.

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