scholarly journals Baseline Characteristics of 412 Hodgkin's Lymphoma Patients Diagnosed between July 2015 and May 2018: A Report from China Lymphoma Patient Registry (CLAP)

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 5362-5362
Author(s):  
Huilai Zhang ◽  
Yuqin Song ◽  
Aichun Liu ◽  
Haiyan Yang ◽  
Xinan Cen ◽  
...  
Keyword(s):  
Medical Records ◽  
Initial Treatment ◽  
Hodgkin’S Lymphoma ◽  
Hodgkin's Lymphoma ◽  
Newly Diagnosed ◽  
Demographic Information ◽  
Cancer Hospital ◽  
History Of ◽  
Baseline Characteristics ◽  
Patient Demographic Information

Abstract Introduction Lymphoma is the most common hematologic tumor with about 88000 newly diagnosed cases in China in 2015 (Chen et.al, CA Cancer J Clin 2016). To better understand the epidemiology, treatment and prognosis of lymphoma in China, Beijing Cancer Hospital and other four hospitals jointly launched China Lymphoma Patient Registry (CLAP) study (NCT03313271) in early 2017. By the end of March 2018, a total of 3458 lymphoma patients, including 412 Hodgkin's Lymphoma (HL) cases and 3046 Non-Hodgkin's Lymphoma (NHL) cases, had been prospectively and retrospectively recruited. Here we report the baseline characteristics and initial treatment of HL patients diagnosed between July 2015 and March 2018. Method This is an observational bi-directional cohort study based on medical records of hospitalized lymphoma patients. Inclusion criteria of this study include: 1) newly diagnosed as HL after July 2015 in five participating hospitals; 2) age >=18 yrs old at time of disease diagnosed; 3) given informed consent if prospective follow-up is needed. This study has been approved by Institutional Review Board (IRB) of all study sites. Medical records of newly diagnosed adult HL patients in five participating hospitals were systematically reviewed. Study data, including patient demographic information, disease baseline characteristics, treatment options and prognosis were manually entered or directly transferred into a predesigned electronic database with the support of Medbanks Network Technology Co., Ltd. In this study, descriptive analysis was used to understand the distribution of patient demographic information (age, gender, medical history, etc.), disease baseline characteristics (symptom, score, stage, etc.) and initial treatment option (if ABVD) for HL population as a whole as well as by subtype stratification. Result A total of 412 HL patients were identified between July 2015 and March 2018. Among all HL patients, nodular sclerosis type of classic Hodgkin's lymphoma (NSCHL) was the most common subtype (53.6%) followed by mixed cell type of classic Hodgkin's lymphoma (MCCHL) (23.1%)(Figure1). All classic subtypes accounted for over 93% of all HL patients. Male is more common than female (60.4%vs39.6%), especially for nodular lymphocytes predominant type of HL (NLPHL). However, no statistical significant gender difference was observed across different subtypes. Age of NSCHL patients was relative younger than patients with other subtypes with a median age of 31. The general health status of most HL patients was relative good at first diagnosis, the percentage (excluding missing) of patient with recorded B symptoms and ECOG score >=2 were 42.4% and 2%, respectively. The distribution of clinical staging was 4.9%, 46.1%, 18.2% and 26.5% for I-IV respectively. Doxorubicin, Bleomycin, Vincristine, Dacarbazine (ABVD) contained regimen was the most common initial treatment regimen and was received by 72% of HL patients and no statistical significant difference was observed in term of ABVD use across HL subtypes (Table1). Hypertension was the most common comorbidity and 7% HL patients had reported concomitant hypertension followed by diabetes (4.4%), hepatitis B (1.9%) and tuberculosis (1.0%) (Figure2). Previous personal history of cancer and family history of cancer were reported by 1.7% and 9.2% of study subjects, respectively (Figure3). Conclusion Compared with Non-Hodgkin's Lymphoma, HL is less common, less aggressive and attracts less attention from researchers. In 2013, only about 700 HL newly diagnosed cases were reported, accounting for 5.4% of total lymphoma patients in the country (He, Chen, Chinese Cancer Registry Annual Report 2016). Although some multi-center studies had reported the pathology distribution of HL (Sun et.al, Am J Clin Pathol 2012; Cao et.al, Ann Diagn Pathol. 2018), very few of them have more detailed information on disease characteristics and treatment. As one of the biggest observational studies focus on HL in the country as well as in the region, this registry provides a unique opportunity and platform to understand the whole picture of HL diagnosis, treatment and prognosis in real world. Disclosures Song: Peking University Cancer Hospital (Beijing Cancer Hospital): Employment. Zhu:Beijing Cancer Hospital: Employment.

scholarly journals Baseline Characteristics of 3046 Non-Hodgkin's Lymphoma Patients Diagnosed between July 2015 and May 2018: A Report from China Lymphoma Patient Registry (CLAP)

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 5394-5394
Author(s):  
Yuqin Song ◽  
Huilai Zhang ◽  
Haiyan Yang ◽  
Aichun Liu ◽  
Xinan Cen ◽  
...  
Keyword(s):  
Medical Records ◽  
Hodgkin’S Lymphoma ◽  
Cell Lymphoma ◽  
B Cell Lymphoma ◽  
Hodgkin's Lymphoma ◽  
Newly Diagnosed ◽  
Lymphoma Patient ◽  
Cancer Hospital ◽  
History Of ◽  
Baseline Characteristics

Abstract Introduction Lymphoma is the most common hematologic tumor. In 2015 about 88000 new cases was estimated diagnosed in China (Chen et.al, CA Cancer J Clin 2016). China Lymphoma Patient Registry (CLAP) (NCT03313271) is an observational bi-directional cohort study launched in five hospitals in early 2017, aiming to better understand the epidemiology, treatment and prognosis of lymphoma in the country. By the end of March 2018, a total of 3458 lymphoma patients, including 412 Hodgkin's Lymphoma (HL) cases and 3046 Non-Hodgkin's Lymphoma (NHL) cases, had been prospectively and retrospectively recruited. Here we report the demographic and disease baseline characteristics of 3046 NHL patients diagnosed between July 2015 and March 2018. Method This is an observational bi-directional cohort study based on medical records of hospitalized lymphoma patients in five CLAP hospitals. In order to be eligible for this particular analysis, patients need to be 1) newly diagnosed as NHL between July 2015 and March 2018 in five participating hospitals; 2) age >=18 yrs old at time of disease diagnosis; 3) given informed consent if prospective follow-up is needed. This study has been approved by Institutional Review Board (IRB) from all study sites. Medical records of newly diagnosed NHL patients were systematically reviewed and study data were manually entered or directly transferred into a predesigned electronic database with the support of Medbanks Network Technology Co., Ltd. Descriptive analysis was used to understand the distribution of patient demographic information (age, gender, medical history, etc.), disease baseline characteristics (symptoms, score, stage, etc.) and initial treatment options (if Rituximab) for NHL population as a whole as well as by subtype stratification. Result A total of 3046 newly diagnosed NHL patients were identified between July 2015 and March 2018, and diffuse large B cell lymphoma (DLBCL) was the most common subtype (48.2%)(Figure1). Males accounted for 55.4% of the total study population and were very dominant in mantle cell lymphoma (MCL) (79.8%), but females were more common in Follicular lymphoma (FL) (53.7%) and Marginal zone lymphoma (MZL) (52.8%). The median age of all study subjects was 58yrs old (range 18-95) and patients with FL (51yrs) and T-cell lymphoma (TCL) (52yrs) was relative younger compared with other subtypes. The general health status of most NHL patients was relative good at first diagnosis, the percentage (excluding missing) of patient with recorded B symptoms, ECOG-PS score >=2 and IPI score3-5 were 39.0%, 4.8% and 26.8%, respectively. Among B-cell lymphoma (BCL), Rituximab was most frequently used in patients with FL (63.4%) followed by DLBCL (61.1%), and MCL (58.5%) (table1). Hypertension was the most common comorbidity and over 16% NHL patients had reported concomitant hypertension followed by diabetes (7.9%), hepatitis B (4.4%), coronary heart disease (3.3%) and tuberculosis (1.4%) (Figure2). Previous personal history of cancer and family history of cancer were reported by 2.8% and 12.5% of study subjects, respectively (Figure3). Conclusion Among all CLAP participants, NHL accounts for nearly 90% of all lymphoma patients, which is consistent with the report from national cancer registry (He, Chen, Chinese Cancer Registry Annual Report 2016) and demonstrates a well representativeness of NHL patients in China. NHL is a composite of many types of lymphoma and each subtype had unique histological, clinical and prognostic characteristics. Although previous studies had reported the pathology distribution of NHL in China (Sun et.al, Am J Clin Pathol 2012; Cao et.al, Ann Diagn Pathol. 2018), very few have more detailed information on disease characteristics and treatment. As a big observational study focus on lymphoma, this registry provides a unique opportunity and platform to understand the whole picture of NHL diagnosis, treatment and prognosis in real world. Disclosures Song: Peking University Cancer Hospital (Beijing Cancer Hospital): Employment. Zhu:Beijing Cancer Hospital: Employment.

scholarly journals Prevalence and Risk Predictive Factors of Comorbid Malignancies in Patients with Chronic Myeloid Leukemia

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 1900-1900
Author(s):  
Tong-Yoon Kim ◽  
Sung-Eun Lee ◽  
Soo-Hyun Kim ◽  
Soo-Young Choi ◽  
Eun-Jung Jang ◽  
...  
Keyword(s):  
Board Of Directors ◽  
Medical Records ◽  
Myeloid Leukemia ◽  
Research Funding ◽  
Hodgkin’S Lymphoma ◽  
Hodgkin's Lymphoma ◽  
Advisory Committees ◽  
History Of

Abstract Introduction: As chronic myeloid leukemia (CML) patents are generally diagnosed at old age and live longer by active use of BCR-ABL1 tyrosine kinase inhibitors (TKIs), the occurrence of other malignancy (OM) is becoming a critical issue as a long-term comorbidity. An increased rate of OM has been reported in myeloproliferative disorders and long-term TKI treatment may induce OM in CML. To explore exact prevalence and characteristics of OM, we reviewed medical records of CML patients and compared with those of age-matched Korean population. Methods: The medical records of 1,469 CML patients who diagnosed between January 2000 and December 2014 were reviewed using Korean data-set of Asia CML Registry (ACR). With a cut-off date of July 2016, age-standardized prevalence rates (A-SPR) of OM (except benign tumors and other leukemias) were analyzed and compared with that of general population in Korea Central Cancer Registry (KCCR). In addition, we analyzed cumulative incidence rate of OM and various risk factors. Results: The median duration of follow-up was 84 (1-197) months, and 96 CML patients had at least one OM. Forty three patients had a history of OM before a median 69 (1-161) months of CML diagnosis and 53 patients developed OM after a median 53 (range; 0.2-172) months of CML diagnosis. The OM included 32 thyroid cancers, 19 colorectal cancers, 16 stomach cancers, 9 breast cancers, 4 gynecological cancers (3 cervical cancers and 1 uterine endometrial cancers), 3 lymphoma (2 non-Hodgkin's lymphoma and 1 Hodgkin's lymphoma), 3 biliary cancer, 3 skin cancers, 3 prostate cancers, 2 lung cancer, 2 tongue cancer, 2 liver cancer, 2 esophageal cancer, 1 pancreatic cancer, and 1 bladder cancer.A-SPR of OM was 1.7 times higher in CML patients. Hodgkin's lymphoma (8.7 times), thyroid cancer (2.6 times), biliary cancer (2.6 times), colorectal cancer (2 times), non-Hodgkin's lymphoma (1.8 times), cervical cancer (1.8 times), and breast cancer (1.6 times) had a higher A-SPR. On the other hands, skin cancer (3.3 times), lung cancer (2 times), and liver cancer (2 times) were lower than that of general population. With 53 patients who had OM after CML diagnosis, we analyzed the cumulative incidence. The risk of OM was increased over the follow-up period (2.7% at 7 years) Univariate analysis revealed that patients who were more than 37 years old at CML diagnosis (4.3% vs. 0.4%, p<0.001) and who had family history of cancer (8.2% vs. 2.3%, p=0.002) were associated with a higher OM. After adjusting for factors, multivariate analysis showed that older age (HR of 4.19, P<0.001) and family history (HR of 3.17, P=0.001) were independently associated with increased risk. There was no difference in 7-year overall survival (OS) between patients with OM (n=96) and without OM (n=1,373) (84.9% vs. 86.9%, p=0.573). However advanced cancer stages (stage 3 and 4) of OM significantly affected poor OS ( 88.3% vs. 65.6% P=0.0406). Conclusion: Although comorbid malignancies did not significantly affect CML survival, poor survival in advanced stages and the high risk of other cancers warn the need of systematic screening in long-term CML survivors. In addition, the specific cancer types with a significantly higher A-SPR should be considered for further studies including genetic mechanisms. Disclosures Kim: ILYANG: Consultancy, Honoraria, Research Funding; Pfizer: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau; Novartis: Consultancy, Honoraria, Research Funding, Speakers Bureau; BMS: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau.

scholarly journals Pattern of Rituximab Use Among Patients with B-Cell Non-Hodgkin's Lymphoma: A Report from China Lymphoma Patient Registry (CLAP)

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 5419-5419
Author(s):  
Haiyan Yang ◽  
Yuqin Song ◽  
Huilai Zhang ◽  
Aichun Liu ◽  
Xinan Cen ◽  
...  
Keyword(s):  
Logistic Regression ◽  
B Cell ◽  
Medical Records ◽  
Initial Treatment ◽  
Cell Lymphoma ◽  
Multiple Logistic Regression ◽  
Lymphoma Patient ◽  
Factors Associated ◽  
Disease Characteristics ◽  
Cancer Hospital

Abstract Introduction: Rituximab is a chimeric monoclonal antibody against the protein CD20 and has been wildly used in the treatment of CD20-positive, B-cell Non-Hodgkin's Lymphoma (NHL). Many studies have demonstrated the effect and safety of Rituximab both in China and international. However, the pattern of real-world Rituximab use in China still remains unclear, although the country is trying very hard to lower the barrier of anti-cancer drug access. In this study, we reported the pattern of Rituximab use during initial treatment and factors associated with Rituximab use among B-cell NHL patients in China Lymphoma Patient Registry (CLAP) study (NCT03313271). Method: CLAP is a multi-center observational bi-directional cohort study based on medical records of hospitalized lymphoma patients and was launched in early 2017 in five hospitals. Medical records of the eligible patients in participating hospitals were systematically reviewed and study data were manually entered or directly transferred into a predesigned electronic database with the support of Medbanks Network Technology Co., Ltd. Its inclusion criteria include: 1) newly diagnosed as lymphoma in participating hospitals; 2) age >=18 yrs old at time of disease diagnosed; 3) given informed consent if prospective follow-up is needed. In order to be eligible for this particular report, three additional criteria were applied: 1) diagnosis was made after July 2015; 2) with clear diagnosis of one of B-cell NHL subtypes, including diffuse large B-cell lymphoma (DLBCL), follicular lymphoma (FL), small lymphocytic lymphoma/chronic lymphocytic leukemia (SLL/CLL), mantle cell lymphoma (MCL) and marginal zone lymphoma (MZL); 3) with recorded initial treatment. Frequency analysis was used to describe the distribution of patient demographics and disease characteristics, stratified by if Rituximab was used. Rituximab use was defined as YES if at least one prescription was made regardless of number of cycles and duration of treatment. Percentage of Rituximab use was also reported by histology subtypes and first prescription time (every 6 months). Multiple logistic regression was used to explore factors associated with Rituximab use during initial treatment. Result: A total of 1634 study subjects were included in this analysis and 1258 of them were treated with Rituximab contained regimen. Among all study subjects, male was slightly more than female (52.4% vs 47.6%) and 85.7% of them were older than 40 yrs. Majority of study subjects (84.9)% had a ECOG score between 0-1 at time of disease diagnosis. The distribution of demographic and disease characteristics was similar between the two groups (Table1). Among the five subtypes, patients with FL had the highest rate of Rituximab use (80.8%), followed by DLBCL (77.2%), MZL (74.3%), MCL (73.3%) and CLL/SLL (57.1%) (Figure1). Using every 6 months as a time period, Rituximab use rate between July 2015 and March 2018 was 71.8%, 77.9%, 70.6%, 78.8%, 87.9% and 93.8% , p-value for trend test was 0.0002(figure2). In multiple logistic regression, CLL/SLL was associated with less Rituximab use comparing with DLBCL (OR=0.439; 95% CI=0.228-0.846) and later time of first prescription was associated with more Rituximab use (OR=1.192; 95% CI=1.088-1.305). Conclusion Closed to 77% B-cell NHL patients received Rituximab contained regimen as their initial treatment, demonstrating the well recognition of the efficacy and safety of Rituximab among doctors in CLAP hospitals. Compared with other subtypes, patients with CLL/SLL had lower Rituximab use rate, which might be contributed to its lower CD20 express (Beum et.al, J Immunol 2006) and suboptimal clinical effect (Robak et.al, J Clin Oncol 2010). In September 2017, Rituximab was covered by the National Basic Medical Insurance and the price was also dropped. Therefore, as a proxy of payment policy improvement and lower access barrier, later time of diagnosis was associated with higher Rituximab use rate. Although not statistical significant, patients with poorer health status (ECOG>=2) was more likely to be prescribed with Rituximab. In conclusion, NHL subtypes and economic reason are two main driven factors that influence the use of Rituximab as initial treatment in real world practice in China. Disclosures Song: Peking University Cancer Hospital (Beijing Cancer Hospital): Employment. Zhu:Beijing Cancer Hospital: Employment.

Bone marrow involvement in Hodgkin's lymphoma: Data from a cancer hospital

2016 ◽  
Vol 5 (6) ◽  
pp. 516 ◽  
Author(s):  
Monica Jain ◽  
Kriti Chauhan ◽  
Pragya Shukla ◽  
RajeshKumar Grover
Keyword(s):  
Bone Marrow ◽  
Hodgkin’S Lymphoma ◽  
Bone Marrow Involvement ◽  
Hodgkin's Lymphoma ◽  
Cancer Hospital

scholarly journals The treatment of progressive non-Hodgkin's lymphoma with intensive chemoradiotherapy and autologous marrow transplantation

Blood ◽  
1990 ◽  
Vol 75 (4) ◽  
pp. 831-838 ◽  
Author(s):  
GL Phillips ◽  
JW Fay ◽  
RH Herzig ◽  
HM Lazarus ◽  
SN Wolff ◽  
...  
Keyword(s):  
Marrow Transplantation ◽  
Hodgkin’S Lymphoma ◽  
Disease Status ◽  
Hodgkin's Lymphoma ◽  
Prior History ◽  
Resistant Disease ◽  
Non Hodgkin’S Lymphoma ◽  
Non Hodgkin's Lymphoma ◽  
Cause Of Failure ◽  
History Of

Abstract Intensive chemoradiotherapy, with or without additional local radiotherapy, and unpurged autologous marrow transplantation was given to 68 patients with progressive non-Hodgkin's lymphoma. Responses were attained in 44 patients (65%, 95% confidence intervals [CI], 52% to 76%), including 37 who achieved complete responses. Fifteen patients (22%, 95% C.I. 13% to 34%) remain free of disease (including 11 continuously) at a median of 5.3 (range 3.1 to 9.1) years later. Higher Karnofsky scores (P less than .01, Mann-Whitney U test) and the absence of a history of prior radiotherapy (P = .02, chi 2 test) were associated with achievement of complete plus partial responses. Higher Karnofsky scores (P less than .01, Mann-Whitney U test) and less resistant disease status at transplantation (P = .04, chi 2 test) were significant when calculations were limited to complete responses. Karnofsky scores were also associated with the probability of freedom from progression (P = .02, log-rank) for responding patients. Also, Karnofsky scores and the absence of prior radiotherapy (P less than .01 and P = .01, respectively, log-rank) were associated with improved survival. Progressive lymphoma was the chief cause of failure; progression usually occurred less than 6 months after transplantation, most often at the sites of active disease before the transplant. However, five patients (including four with high-grade non-Hodgkin's lymphoma) suffered hematogenous patterns of relapse; four of these five patients had no prior history of marrow involvement. Other causes of mortality included interstitial pneumonitis, sepsis, hemorrhage and renal failure. Intensive chemoradiotherapy and autologous marrow transplantation produces durable remissions in some patients with progressive non-Hodgkin's lymphoma. Since such therapy is more effective when given to patients with signs of less advanced disease, earlier treatment would be the simplest way to produce improved results. However, improved conditioning regimens will also be needed, and measures to reduce occult lymphoma stem cell contamination with the autograft may also be required to increase the likelihood of cure in some patients.

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