Effect of Place of Residence and Treatment on Survival Outcomes in Patients With Diffuse Large B‐Cell Lymphoma in British Columbia

271 Background: The Windsor Regional Cancer Program (WRCP) was determined to have consistently been a top performer in time to treatment of diffuse large B cell lymphoma in this Canadian province (http://www.csqi.on.ca/by_type_of_cancer/lymphoma/lymphoma_treatment/). We endeavored to determine whether faster time to diagnosis and treatment for diffuse large B-cell lymphoma (DLBCL) influenced the IPI score (International Prognostic Score), thereby predicting an improved clinical outcome in these presenting patients. Methods: The WRCP services a catchment area of 650,000 people. A retrospective chart review was conducted for patients diagnosed with DLBCL at the Windsor Regional Cancer Program (WRCP) between 2006-2012. Information collected included the five factors for scoring by the International Prognostic Index (IPI) – age, performance status, LDH, stage, and number of extranodal sites – chemotherapy regimen, relapses, existence of second malignancies, cause of death, and dates of diagnosis, last follow-up, and death. We analyzed the relationship between prognostic factors and these clinical outcomes, and also compared the IPI scores for this cohort of patients against a similar population in another Canadian province, British Columbia. Results: It is established that compared to other cancer centres in Ontario, the WRCP is consistently reporting a shorter diagnosis to treatment metric when compared to their counterparts in Ontario, Canada. When compared to historical Canadian data, presenting IPI scores for DLBCL patients were lower on average for patients treated at the WRCP than those reported in British Columbia, Canada by Sehn et al. [Sehn, L. H., et al. (2007). The revised International Prognostic Index is a better predictor of outcome than the standard IPI for patients with diffuse large B-cell lymphoma treated with R-CHOP. Blood, 109(5), 1857-1861.]. Conclusions: A lower presenting IPI score is known to be correlated improved lymphoma related outcome. With attention to the metric of diagnosis to treatment < 30 days for diffuse large B cell lymphoma, we expect an improved lymphoma related outcome for our patients. We recommend ongoing attention to this metric, in order to improve outcomes for our patients.

Download Full-text

Academic Centers Compared With Nonacademic Centers for Patients With International Prognostic Index Risk-stratified Diffuse Large B-cell Lymphoma: A Survival Outcomes Analysis

Clinical Lymphoma Myeloma & Leukemia ◽

10.1016/j.clml.2019.11.012 ◽

2020 ◽

Vol 20 (4) ◽

pp. e174-e183

Author(s):

Daniel A. Ermann ◽

Victoria A. Vardell ◽

Avyakta Kallam ◽

Peter T. Silberstein ◽

James O. Armitage

Keyword(s):

B Cell ◽

Cell Lymphoma ◽

International Prognostic Index ◽

Prognostic Index ◽

B Cell Lymphoma ◽

Survival Outcomes ◽

Outcomes Analysis ◽

Large B Cell Lymphoma ◽

Large B Cell

Download Full-text

Survival outcomes of diffuse large B-cell lymphoma by association with concurrent or antecedent follicular lymphoma and double hit status

Leukemia & Lymphoma ◽

10.1080/10428194.2019.1622099 ◽

2019 ◽

Vol 60 (13) ◽

pp. 3266-3271

Author(s):

Amir Behdad ◽

Craig S. Boddy ◽

Angela J. Fought ◽

Timothy Taxter ◽

Marissa K. Falkiewicz ◽

...

Keyword(s):

Follicular Lymphoma ◽

B Cell ◽

Cell Lymphoma ◽

B Cell Lymphoma ◽

Survival Outcomes ◽

Large B Cell Lymphoma ◽

Double Hit ◽

Large B Cell

Download Full-text

Clinical features and survival outcomes of patients with diffuse large B-cell lymphoma: analysis of web-based data from the Korean Lymphoma Working Party Registry

Blood Research ◽

10.5045/br.2013.48.2.115 ◽

2013 ◽

Vol 48 (2) ◽

pp. 115 ◽

Cited By ~ 3

Author(s):

Hyeon Gyu Yi ◽

Jin Seok Kim ◽

Cheolwon Suh ◽

Won Seog Kim ◽

Jae-Yong Kwak ◽

...

Keyword(s):

B Cell ◽

Clinical Features ◽

Cell Lymphoma ◽

Working Party ◽

B Cell Lymphoma ◽

Survival Outcomes ◽

Web Based ◽

Large B Cell Lymphoma ◽

Large B Cell

Download Full-text

The pretreatment platelet count predicts survival outcomes of diffuse large B-cell lymphoma: an analysis of 1007 patients in the rituximab era

Leukemia Research ◽

10.1016/j.leukres.2021.106715 ◽

2021 ◽

pp. 106715

Author(s):

Haizhu Chen ◽

Yan Qin ◽

Jianliang Yang ◽

Peng Liu ◽

Xiaohui He ◽

...

Keyword(s):

Platelet Count ◽

B Cell ◽

Cell Lymphoma ◽

B Cell Lymphoma ◽

Survival Outcomes ◽

Large B Cell Lymphoma ◽

Large B Cell

Download Full-text

CD5-Positive Marginal Zone Lymphoma: Clinicopathological Features And Survival Outcomes

10.21203/rs.3.rs-948719/v1 ◽

2021 ◽

Author(s):

Yaqin Xia ◽

Jurui Ge ◽

Zhenchang Sun ◽

Feifei Nan ◽

Wenjuan Wan ◽

...

Keyword(s):

B Cell ◽

Marginal Zone ◽

Cell Lymphoma ◽

B Cell Lymphoma ◽

Marginal Zone Lymphoma ◽

Clinicopathological Features ◽

Survival Outcomes ◽

Large B Cell Lymphoma ◽

Significant Difference ◽

Large B Cell

Abstract Background: CD5 expression in diffuse large B-cell lymphoma has a poor prognosis but the prognostic value of CD5 expression in marginal zone lymphoma is undefined. Methods: Clinicopathological features, survival outcomes, and prognostic implications of marginal zone lymphoma were retrospectively analyzed in 204 patients. We classified patients into (i) CD5-positive marginal zone lymphoma (ii) CD5-negative marginal zone Lymphoma, Fisher's exact test was used to compare the CD5-positive and CD5-negative marginal zone lymphoma. Progression-free survival (PFS) and overall survival (OS) curves were summarized by Kaplan-Meier method and compared using the log-rank test, The Cox proportional hazard regression model was used for univariate and multivariate analyses. Results: CD5 expression is rare in marginal zone lymphoma, of 204 patients, only 48 (23.53%) had CD5-positive. Due to the characterized of slow growth and locally aggressive nature, the prognosis is favorable after treatment. at the end of the followup 179 patients were still alive,163 patients never progressed. The 5-year PFS and OS rates for marginal zone lymphoma were 65.10% and 77.30% respectively, the 5-year PFS and OS rates for CD5-positive marginal zone lymphoma were 64.80% and 84.10%, there is no significant difference between CD5-positive and CD5-negative ( P =0.829, P =0.521). Diffuse large B-cell lymphoma (DLBCL) transformation was pathologically indicated in 6 patients, of which 5(83.33%) patients were CD5-positive marginal zone lymphoma. Conclusion: CD5 expression in marginal zone lymphoma is not independently prognostic for PFS and OS. But CD5-positive marginal zone lymphoma seems more likely to transformation to diffuse large B-cell lymphoma.

Download Full-text

Impact of R-CHOP dose intensity on survival outcomes in diffuse large B-cell lymphoma: a systematic review

Blood Advances ◽

10.1182/bloodadvances.2021004665 ◽

2021 ◽

Vol 5 (9) ◽

pp. 2426-2437

Author(s):

Edward J. Bataillard ◽

Chan Yoon Cheah ◽

Matthew J. Maurer ◽

Arushi Khurana ◽

Toby A. Eyre ◽

...

Keyword(s):

Systematic Review ◽

B Cell ◽

Cell Lymphoma ◽

Multivariable Analysis ◽

Dose Intensity ◽

B Cell Lymphoma ◽

Survival Outcomes ◽

Large B Cell Lymphoma ◽

The Impact ◽

Large B Cell

Abstract The dilemma of whether to treat elderly patients with diffuse large B-cell lymphoma (DLBCL) with a full or reduced dose intensity (DI) of R-CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisolone+rituximab) is often faced by clinicians. We conducted a systematic review assessing the impact of R-CHOP DI on DLBCL survival outcomes, according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Protocols (PRISMA-P) guidelines. We searched MEDLINE, EMBASE, and Cochrane CENTRAL for studies with ≥100 patients treated with R-CHOP/R-CHOP–like therapies published from January 2002 through November 2020. Studies were included if they reported the impact of R-CHOP DI on survival outcomes. We screened records, extracted data, and reviewed all the studies for quality and statistical appraisal. Of 380 screened records, 13 studies including 5188 patients were reviewed. DI was often calculated as the ratio of the cumulative delivered dose of prespecified drug(s) to the cumulative planned dose multiplied by a time-correction factor. Lower DI (intended or relative) was associated with inferior survival in 7 of 9 studies reporting crude survival analyses. Multivariable analysis using DI as a covariate was performed in 10 studies. Six showed an association (P < .05) with adjustment for other covariates, and 4 did not. Most studies and those larger studies of higher quality showed poorer outcomes associated with reduced DI. In subgroups aged ≥80 years, survival was not consistently affected by reduced DI. DI-specific randomized trials are warranted, but these data support full-dose R-CHOP in elderly and fit patients aged <80 years with DLBCL, but not in those aged ≥80 years, where dose-reduced R-CHOP does not appear to compromise survival.

Download Full-text