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.
Abstract
<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 |
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