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, TA, Ireland, R, Hodson, A, Walewska, R, Ardeshna, K, Chaganti, S, McKay, P, Davies, A, Fox, CP
et al (show 2 more authors) (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). pp. 134-143.

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<h4>Background</h4>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.<h4>Methods</h4>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.<h4>Results</h4>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.<h4>Conclusions</h4>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.

Item Type: Article
Uncontrolled Keywords: Humans, Cyclophosphamide, Vincristine, Doxorubicin, Prednisone, Antineoplastic Combined Chemotherapy Protocols, Ambulatory Care, Survival Rate, Retrospective Studies, Databases, Factual, Aged, Aged, 80 and over, England, Lymphoma, Large B-Cell, Diffuse, Rituximab, Practice Patterns, Physicians'
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Systems, Molecular and Integrative Biology
Depositing User: Symplectic Admin
Date Deposited: 19 Jan 2022 10:27
Last Modified: 18 Jan 2023 21:15
DOI: 10.1038/s41416-021-01525-4
Open Access URL: https://doi.org/10.1038/s41416-021-01525-4
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3147181