Contributions
Abstract: PB1720
Type: Publication Only
Background
The incidence of lymphomas is increasing with age. Many aggressive lymphomas are now considered to be curable. All fit patients, even elders, are candidates for optimal treatment with a curative intent. Diffuse Large B Cell Lymphoma (DLBCL) is the most common non-Hodgkin Lymphoma, with 60% of curative rates after standard R-CHOP regimen. Patients that relapse can be rescued with salvage treatment in 20-30%. The elders are not considered for full standard treatment in many centers. Geriatric scales are starting to being used to stratify patients and offer them individualized treatments. The use of GSCF for neutropenia prophylaxis is not a standard of care in this population.
Aims
The objectives of this study were: 1) Validate CIRS score in a DLBCL cohort; 2) Analyse the impact of CIRS score in OS; 3) Analyse the impact of GSCF prophylaxis for neutropenic fever.
Methods
Results
In our series, 20 patients (48%) were males. Median age at diagnosis was 73 years old (range 60-90) With a median follow-up of 32 mo. (range 0-96), the median PFS was 51 months and the OS was 61 mo. The patients were stratified by the R-IPI and the NCCN-IPI. The ROC analysis showed a scoring of 5,5 in CIRS to identify two different risk groups, with an AUC of 70,5%, a sensibility of 87% and a specificity of 48% (p=0,02). In the low risk group, with CIRS <6 (n=17), 7 (41%) patients were admitted with a mean of stay of 6,2 days (range 1-16) vs the high-risk group with CIRS >6 (n=24). Of this group, 11(45%) patients were admitted with a mean of stay of 10,6 days (range 1-62), p=0,035. The CIRS scale was also used to discriminate two OS groups; the low risk showed a median OS not reached vs 29 mo. the high-risk group, with a Hazard ratio of 2,68 (CI95%: 1,031-5,882, p= 0,042). NF was the most common ER visit, n=18 (36%). Of the 18 patients with NF, 10 (55%) were prescribed with GCSF prophylaxis mid cycles. Of all patients with GCSF (n=43) only 10 (24%) NF were reported. 11/17 patients (65%) who didn’t use GCSF prophylaxis had an NF episode. The Odds ratio (OR) for the patients under prophylaxis was 0,232 (CI 95%: 0,085-0,634, p=0,004).
Conclusion
Session topic: 20. Aggressive Non-Hodgkin lymphoma - Clinical
Keyword(s): Aging, Non-Hodgkin's lymphoma, neutropenia
Abstract: PB1720
Type: Publication Only
Background
The incidence of lymphomas is increasing with age. Many aggressive lymphomas are now considered to be curable. All fit patients, even elders, are candidates for optimal treatment with a curative intent. Diffuse Large B Cell Lymphoma (DLBCL) is the most common non-Hodgkin Lymphoma, with 60% of curative rates after standard R-CHOP regimen. Patients that relapse can be rescued with salvage treatment in 20-30%. The elders are not considered for full standard treatment in many centers. Geriatric scales are starting to being used to stratify patients and offer them individualized treatments. The use of GSCF for neutropenia prophylaxis is not a standard of care in this population.
Aims
The objectives of this study were: 1) Validate CIRS score in a DLBCL cohort; 2) Analyse the impact of CIRS score in OS; 3) Analyse the impact of GSCF prophylaxis for neutropenic fever.
Methods
Results
In our series, 20 patients (48%) were males. Median age at diagnosis was 73 years old (range 60-90) With a median follow-up of 32 mo. (range 0-96), the median PFS was 51 months and the OS was 61 mo. The patients were stratified by the R-IPI and the NCCN-IPI. The ROC analysis showed a scoring of 5,5 in CIRS to identify two different risk groups, with an AUC of 70,5%, a sensibility of 87% and a specificity of 48% (p=0,02). In the low risk group, with CIRS <6 (n=17), 7 (41%) patients were admitted with a mean of stay of 6,2 days (range 1-16) vs the high-risk group with CIRS >6 (n=24). Of this group, 11(45%) patients were admitted with a mean of stay of 10,6 days (range 1-62), p=0,035. The CIRS scale was also used to discriminate two OS groups; the low risk showed a median OS not reached vs 29 mo. the high-risk group, with a Hazard ratio of 2,68 (CI95%: 1,031-5,882, p= 0,042). NF was the most common ER visit, n=18 (36%). Of the 18 patients with NF, 10 (55%) were prescribed with GCSF prophylaxis mid cycles. Of all patients with GCSF (n=43) only 10 (24%) NF were reported. 11/17 patients (65%) who didn’t use GCSF prophylaxis had an NF episode. The Odds ratio (OR) for the patients under prophylaxis was 0,232 (CI 95%: 0,085-0,634, p=0,004).
Conclusion
Session topic: 20. Aggressive Non-Hodgkin lymphoma - Clinical
Keyword(s): Aging, Non-Hodgkin's lymphoma, neutropenia