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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

Hounsome, L.; Eyre, T. A.; Ireland, R.; Hodson, A.; Walewska, R.; Ardeshna, K.; Chaganti, S.; McKay, P.; Davies, A.; Fox, C. P.; Kalakonda, N.; Fields, P. A.

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 Thumbnail


Authors

L. Hounsome

T. A. Eyre

R. Ireland

A. Hodson

R. Walewska

K. Ardeshna

S. Chaganti

P. McKay

A. Davies

CHRIS FOX Christopher.Fox@nottingham.ac.uk
Clinical Professor in Haematology

N. Kalakonda

P. A. Fields



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.

Citation

Hounsome, L., Eyre, T. A., Ireland, R., Hodson, A., Walewska, R., Ardeshna, K., …Fields, P. A. (2022). 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. British Journal of Cancer, 126(1), 134-143. https://doi.org/10.1038/s41416-021-01525-4

Journal Article Type Article
Acceptance Date Aug 11, 2021
Online Publication Date Oct 5, 2021
Publication Date Jan 1, 2022
Deposit Date Feb 8, 2023
Publicly Available Date Feb 8, 2023
Journal British Journal of Cancer
Print ISSN 0007-0920
Electronic ISSN 1532-1827
Publisher Springer Science and Business Media LLC
Peer Reviewed Peer Reviewed
Volume 126
Issue 1
Pages 134-143
DOI https://doi.org/10.1038/s41416-021-01525-4
Keywords Cancer Research; Oncology
Public URL https://nottingham-repository.worktribe.com/output/17078621
Publisher URL https://www.nature.com/articles/s41416-021-01525-4

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