THE IMPROVING OUTCOME OF NON-HODGKIN LYMPHOMA (NHL) WITHIN 15 YEARS PERIOD – REAL WORLD DATA OF NATIONAL-WIDE LYMPHOMA PROJECT
(Abstract release date: 05/19/16)
EHA Library. Trneny M. 06/09/16; 132707; E1158
Prof. Dr. Marek Trneny
Contributions
Contributions
Abstract
Abstract: E1158
Type: Eposter Presentation
Background
Non-Hodgkin’s lymphomas (NHL) represent the most common hematologic cancer with increasing incidence over the years. Number of clinical trials demonstrated improved outcome of different NHL subtypes, the national- wide studies describing real world data are however limited. Lymphoma Project established by Czech Lymphoma Study Group (LP-CLSG) in 1999 is focused on prospective collection of NHL patients data since that time.
Aims
The aim of this study is to analyze key data of patients diagnosed and entered into this project during the period 1999-2014.
Methods
The data National Cancer Registry (NCR) were used for incidence and mortality population based figures. Web based utility was developed for LP-CLSG, each center (17 with >50 pts.) is responsible for entering the data of consecutive newly diagnosed lymphoma patients, the central data office is responsible for validation of data. Pathology review were performed in dedicated reference centers. The project is approved by ECs.
Results
The NHL incidence and mortality resp. has been observed to increase from 6.1 and 3.6 resp. in 1981 to 10.8 and 6.0 resp. in 2001 and to 13.5 and 5.3 (decrease) per 100,000 resp. in 2011 (data from population based NCR). Altogether 11 828 patients were recorded in the specific Lymphoma Project in the period 1999-2014, 10 333 with B or T-cell NHL had the reference center pathology review and were included into the analysis. More than 2/3 of all newly diagnosed cases in Czech republic is covered by the project. There were 4187 (40.5%) DLBCL pts., 1969 (19.5%) FL, 885 (8.6%) MZL, 857 (8.3%) MCL, 393 (3.8%) SLL and 1252 (12.5%) other or unclassified B-NHL pts. T-NHL cohort consisted of 283 (2.7% ) PTC NOS pts., 198 (1.9%) ALCL and 309 (3,0%) other T-NHL. There was no trend for increase or decrease of any NHL subtype during the observation period. The median age at the diagnosis was 62 (17-97) and there were similar proportion of men (51.2%) and women (48.8%). Altogether 9,718 had sufficient data for therapy and survival. The median OS for B-NHL and T-NHL was 13.0 and 3.4 y resp. The median OS for B-NHL patients treated with chemotherapy (CHT) and rituximab-chemotherapy (R-CHT) were 8.7 and not reached resp. with probability death risk reduction (DRR) of 36 % (HR 0.64 p<0.0001). It was mainly due to DLBCL outcome improvement with median OS 5.9 years for CHT group vs. unreached for R-CHT group, with DRR of 44 % (HR 0.56, 95%CI; 0.44-0.57, p<0.0001). The OS was significantly improved by rituximab addition to chemotherapy in FL with HR 0.76 (95%CI; 0.59-0.92, p- 0.012), MCL with HR 0.67 (95%CI; 0.49-0.82, p<0.001), SLL with HR 0.60 (95%CI;0.40-0.85, p<0.01), MZL did not show rituximab benefit in this analysis. The significant OS improvement in all NHL diagnosed in current period (2009-2014) was observed compared to period 15 years ago (1999-2002) with DRR by 14% (HR 0.86, 95%CI; 0.74-0.91, p<0.001) This is mainly due to the B-NHL outcome improvement with HR 0.87 (95%CI;0.75-0.92, p<0.005), there was trend for T-NHL outcome improvement (HR 0.82) but it was not significant (p 0.20).
Conclusion
The analysis of the large national-wide population has revealed: 1. The lymphoma incidence is more than doubled during last 30 years whereas the mortality started decrease since 2001 after rituximab introduction. 2. The significant NHL outcome improvement in B-NHL mainly due to rituximab addition with HR 0.56 for DLBCL, 0.76 for FL, 0.67 for MCL and 0.60 for SLL. Other factors could however play the role since 3. There is insignificant trend for outcome improvement of T-NHL as well. 4. The lymphoma project allows the detailed subanalysis of different lymphoma subtypes and different therapeutic approaches, which will be presented. Supported by grant: AZV CR 16-31092A
Session topic: E-poster
Keyword(s): Non-Hodgkin's lymphoma, Population, Survival
Type: Eposter Presentation
Background
Non-Hodgkin’s lymphomas (NHL) represent the most common hematologic cancer with increasing incidence over the years. Number of clinical trials demonstrated improved outcome of different NHL subtypes, the national- wide studies describing real world data are however limited. Lymphoma Project established by Czech Lymphoma Study Group (LP-CLSG) in 1999 is focused on prospective collection of NHL patients data since that time.
Aims
The aim of this study is to analyze key data of patients diagnosed and entered into this project during the period 1999-2014.
Methods
The data National Cancer Registry (NCR) were used for incidence and mortality population based figures. Web based utility was developed for LP-CLSG, each center (17 with >50 pts.) is responsible for entering the data of consecutive newly diagnosed lymphoma patients, the central data office is responsible for validation of data. Pathology review were performed in dedicated reference centers. The project is approved by ECs.
Results
The NHL incidence and mortality resp. has been observed to increase from 6.1 and 3.6 resp. in 1981 to 10.8 and 6.0 resp. in 2001 and to 13.5 and 5.3 (decrease) per 100,000 resp. in 2011 (data from population based NCR). Altogether 11 828 patients were recorded in the specific Lymphoma Project in the period 1999-2014, 10 333 with B or T-cell NHL had the reference center pathology review and were included into the analysis. More than 2/3 of all newly diagnosed cases in Czech republic is covered by the project. There were 4187 (40.5%) DLBCL pts., 1969 (19.5%) FL, 885 (8.6%) MZL, 857 (8.3%) MCL, 393 (3.8%) SLL and 1252 (12.5%) other or unclassified B-NHL pts. T-NHL cohort consisted of 283 (2.7% ) PTC NOS pts., 198 (1.9%) ALCL and 309 (3,0%) other T-NHL. There was no trend for increase or decrease of any NHL subtype during the observation period. The median age at the diagnosis was 62 (17-97) and there were similar proportion of men (51.2%) and women (48.8%). Altogether 9,718 had sufficient data for therapy and survival. The median OS for B-NHL and T-NHL was 13.0 and 3.4 y resp. The median OS for B-NHL patients treated with chemotherapy (CHT) and rituximab-chemotherapy (R-CHT) were 8.7 and not reached resp. with probability death risk reduction (DRR) of 36 % (HR 0.64 p<0.0001). It was mainly due to DLBCL outcome improvement with median OS 5.9 years for CHT group vs. unreached for R-CHT group, with DRR of 44 % (HR 0.56, 95%CI; 0.44-0.57, p<0.0001). The OS was significantly improved by rituximab addition to chemotherapy in FL with HR 0.76 (95%CI; 0.59-0.92, p- 0.012), MCL with HR 0.67 (95%CI; 0.49-0.82, p<0.001), SLL with HR 0.60 (95%CI;0.40-0.85, p<0.01), MZL did not show rituximab benefit in this analysis. The significant OS improvement in all NHL diagnosed in current period (2009-2014) was observed compared to period 15 years ago (1999-2002) with DRR by 14% (HR 0.86, 95%CI; 0.74-0.91, p<0.001) This is mainly due to the B-NHL outcome improvement with HR 0.87 (95%CI;0.75-0.92, p<0.005), there was trend for T-NHL outcome improvement (HR 0.82) but it was not significant (p 0.20).
Conclusion
The analysis of the large national-wide population has revealed: 1. The lymphoma incidence is more than doubled during last 30 years whereas the mortality started decrease since 2001 after rituximab introduction. 2. The significant NHL outcome improvement in B-NHL mainly due to rituximab addition with HR 0.56 for DLBCL, 0.76 for FL, 0.67 for MCL and 0.60 for SLL. Other factors could however play the role since 3. There is insignificant trend for outcome improvement of T-NHL as well. 4. The lymphoma project allows the detailed subanalysis of different lymphoma subtypes and different therapeutic approaches, which will be presented. Supported by grant: AZV CR 16-31092A
Session topic: E-poster
Keyword(s): Non-Hodgkin's lymphoma, Population, Survival
Abstract: E1158
Type: Eposter Presentation
Background
Non-Hodgkin’s lymphomas (NHL) represent the most common hematologic cancer with increasing incidence over the years. Number of clinical trials demonstrated improved outcome of different NHL subtypes, the national- wide studies describing real world data are however limited. Lymphoma Project established by Czech Lymphoma Study Group (LP-CLSG) in 1999 is focused on prospective collection of NHL patients data since that time.
Aims
The aim of this study is to analyze key data of patients diagnosed and entered into this project during the period 1999-2014.
Methods
The data National Cancer Registry (NCR) were used for incidence and mortality population based figures. Web based utility was developed for LP-CLSG, each center (17 with >50 pts.) is responsible for entering the data of consecutive newly diagnosed lymphoma patients, the central data office is responsible for validation of data. Pathology review were performed in dedicated reference centers. The project is approved by ECs.
Results
The NHL incidence and mortality resp. has been observed to increase from 6.1 and 3.6 resp. in 1981 to 10.8 and 6.0 resp. in 2001 and to 13.5 and 5.3 (decrease) per 100,000 resp. in 2011 (data from population based NCR). Altogether 11 828 patients were recorded in the specific Lymphoma Project in the period 1999-2014, 10 333 with B or T-cell NHL had the reference center pathology review and were included into the analysis. More than 2/3 of all newly diagnosed cases in Czech republic is covered by the project. There were 4187 (40.5%) DLBCL pts., 1969 (19.5%) FL, 885 (8.6%) MZL, 857 (8.3%) MCL, 393 (3.8%) SLL and 1252 (12.5%) other or unclassified B-NHL pts. T-NHL cohort consisted of 283 (2.7% ) PTC NOS pts., 198 (1.9%) ALCL and 309 (3,0%) other T-NHL. There was no trend for increase or decrease of any NHL subtype during the observation period. The median age at the diagnosis was 62 (17-97) and there were similar proportion of men (51.2%) and women (48.8%). Altogether 9,718 had sufficient data for therapy and survival. The median OS for B-NHL and T-NHL was 13.0 and 3.4 y resp. The median OS for B-NHL patients treated with chemotherapy (CHT) and rituximab-chemotherapy (R-CHT) were 8.7 and not reached resp. with probability death risk reduction (DRR) of 36 % (HR 0.64 p<0.0001). It was mainly due to DLBCL outcome improvement with median OS 5.9 years for CHT group vs. unreached for R-CHT group, with DRR of 44 % (HR 0.56, 95%CI; 0.44-0.57, p<0.0001). The OS was significantly improved by rituximab addition to chemotherapy in FL with HR 0.76 (95%CI; 0.59-0.92, p- 0.012), MCL with HR 0.67 (95%CI; 0.49-0.82, p<0.001), SLL with HR 0.60 (95%CI;0.40-0.85, p<0.01), MZL did not show rituximab benefit in this analysis. The significant OS improvement in all NHL diagnosed in current period (2009-2014) was observed compared to period 15 years ago (1999-2002) with DRR by 14% (HR 0.86, 95%CI; 0.74-0.91, p<0.001) This is mainly due to the B-NHL outcome improvement with HR 0.87 (95%CI;0.75-0.92, p<0.005), there was trend for T-NHL outcome improvement (HR 0.82) but it was not significant (p 0.20).
Conclusion
The analysis of the large national-wide population has revealed: 1. The lymphoma incidence is more than doubled during last 30 years whereas the mortality started decrease since 2001 after rituximab introduction. 2. The significant NHL outcome improvement in B-NHL mainly due to rituximab addition with HR 0.56 for DLBCL, 0.76 for FL, 0.67 for MCL and 0.60 for SLL. Other factors could however play the role since 3. There is insignificant trend for outcome improvement of T-NHL as well. 4. The lymphoma project allows the detailed subanalysis of different lymphoma subtypes and different therapeutic approaches, which will be presented. Supported by grant: AZV CR 16-31092A
Session topic: E-poster
Keyword(s): Non-Hodgkin's lymphoma, Population, Survival
Type: Eposter Presentation
Background
Non-Hodgkin’s lymphomas (NHL) represent the most common hematologic cancer with increasing incidence over the years. Number of clinical trials demonstrated improved outcome of different NHL subtypes, the national- wide studies describing real world data are however limited. Lymphoma Project established by Czech Lymphoma Study Group (LP-CLSG) in 1999 is focused on prospective collection of NHL patients data since that time.
Aims
The aim of this study is to analyze key data of patients diagnosed and entered into this project during the period 1999-2014.
Methods
The data National Cancer Registry (NCR) were used for incidence and mortality population based figures. Web based utility was developed for LP-CLSG, each center (17 with >50 pts.) is responsible for entering the data of consecutive newly diagnosed lymphoma patients, the central data office is responsible for validation of data. Pathology review were performed in dedicated reference centers. The project is approved by ECs.
Results
The NHL incidence and mortality resp. has been observed to increase from 6.1 and 3.6 resp. in 1981 to 10.8 and 6.0 resp. in 2001 and to 13.5 and 5.3 (decrease) per 100,000 resp. in 2011 (data from population based NCR). Altogether 11 828 patients were recorded in the specific Lymphoma Project in the period 1999-2014, 10 333 with B or T-cell NHL had the reference center pathology review and were included into the analysis. More than 2/3 of all newly diagnosed cases in Czech republic is covered by the project. There were 4187 (40.5%) DLBCL pts., 1969 (19.5%) FL, 885 (8.6%) MZL, 857 (8.3%) MCL, 393 (3.8%) SLL and 1252 (12.5%) other or unclassified B-NHL pts. T-NHL cohort consisted of 283 (2.7% ) PTC NOS pts., 198 (1.9%) ALCL and 309 (3,0%) other T-NHL. There was no trend for increase or decrease of any NHL subtype during the observation period. The median age at the diagnosis was 62 (17-97) and there were similar proportion of men (51.2%) and women (48.8%). Altogether 9,718 had sufficient data for therapy and survival. The median OS for B-NHL and T-NHL was 13.0 and 3.4 y resp. The median OS for B-NHL patients treated with chemotherapy (CHT) and rituximab-chemotherapy (R-CHT) were 8.7 and not reached resp. with probability death risk reduction (DRR) of 36 % (HR 0.64 p<0.0001). It was mainly due to DLBCL outcome improvement with median OS 5.9 years for CHT group vs. unreached for R-CHT group, with DRR of 44 % (HR 0.56, 95%CI; 0.44-0.57, p<0.0001). The OS was significantly improved by rituximab addition to chemotherapy in FL with HR 0.76 (95%CI; 0.59-0.92, p- 0.012), MCL with HR 0.67 (95%CI; 0.49-0.82, p<0.001), SLL with HR 0.60 (95%CI;0.40-0.85, p<0.01), MZL did not show rituximab benefit in this analysis. The significant OS improvement in all NHL diagnosed in current period (2009-2014) was observed compared to period 15 years ago (1999-2002) with DRR by 14% (HR 0.86, 95%CI; 0.74-0.91, p<0.001) This is mainly due to the B-NHL outcome improvement with HR 0.87 (95%CI;0.75-0.92, p<0.005), there was trend for T-NHL outcome improvement (HR 0.82) but it was not significant (p 0.20).
Conclusion
The analysis of the large national-wide population has revealed: 1. The lymphoma incidence is more than doubled during last 30 years whereas the mortality started decrease since 2001 after rituximab introduction. 2. The significant NHL outcome improvement in B-NHL mainly due to rituximab addition with HR 0.56 for DLBCL, 0.76 for FL, 0.67 for MCL and 0.60 for SLL. Other factors could however play the role since 3. There is insignificant trend for outcome improvement of T-NHL as well. 4. The lymphoma project allows the detailed subanalysis of different lymphoma subtypes and different therapeutic approaches, which will be presented. Supported by grant: AZV CR 16-31092A
Session topic: E-poster
Keyword(s): Non-Hodgkin's lymphoma, Population, Survival
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