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Clinical Characteristics and Outcome of Transformed Diffuse Large B-Cell Lymphoma in the Rituximab Era: A SEER Database Analysis
Abstracts median OS from diagnosis (OS1) was 10.6 years (10.1-11.3), and the median OS from transformation (OS2) was 4.3 years (3.4-6.9). Younger patients had a shorter TTT but longer survival (Table 1). Sex was not associated with TTT or survival. Earlier stage at transformation was associated with better survival. Patients transforming from MZL vs FL had a shorter TTT (HR ¼ 1.29 [1.08-1.54]), OS2 (HR ¼ 1.16 [0.88-1.52]), and OS1 (HR ¼ 1.42 [1.09-1.85]). The 2-/5-year OS rates (%) after transformation for patients with a TTT of < 2, 2-5 and > 5 years were 71.4/53.1, 69.7/50.2, and 70.4/53.6, respectively (P ¼ 0.785/0.680). The median OS of transformed DLBCL and age, gender and stage matched de novo DLBCL were 4.3 and 6.5 years, respectively (HR ¼ 0.99 [0.84-1.17], P ¼ 0.932). The 2-/ 5-year OS rates (%) for transformed and de novo DLBCL were 70.5/52.4 and 69.3/55.1, respectively (P ¼ 0.687/0.870). Conclusions: Approximately 25% of transformed DLBCL arise from MZL. Patients with MZL transform earlier and have inferior survival. TTT did not affect OS after transformation. Transformed and de novo DLBCL had similar OS.
to be combined with other targeted agents for DLBCL to achieve optimal clinical efficacy.
NHL-016 Clinical Characteristics and Outcome of Transformed Diffuse Large B-Cell Lymphoma in the Rituximab Era: A SEER Database Analysis Yucai Wang ,1 Yanru Wang,2 Michael Wang,3 Gita Thanarajasingam,1 Carrie Thompson,1 Grzegorz Nowakowski,1 Thomas Habermann,1 Stephen Ansell,1 Thomas Witzig1 1
Mayo Clinic, Rochester, MN, United States; 2Duke Cancer Institute, Duke University Medical Center, Durham, NC, United States; 3The University of Texas MD Anderson Cancer Center, Houston, TX, United States
Context: Follicular lymphoma (FL) and marginal zone lymphoma (MZL) can transform to diffuse large B-cell lymphoma (DLBCL), with a low annual transformation rate. Historically, patients with transformed disease in the pre-rituximab era had a poor outcome with a median post-transformation survival of less than 2 years. Objective: To analyze the clinical characteristics and outcome of DLBCL transformed from FL or MZL in the rituximab era and to compare the survival outcomes of transformed vs de novo DLBCL. Design: Retrospective study using SEER database (19982013). Setting: Population-based cancer registry data analysis. Patients or Other Participants: DLBCL patients with prior diagnosis of FL or MZL; and age, gender and stage matched de novo DLBCL patients. Interventions: N/A. Main Outcomes Measures: Time to transformation (TTT) and overall survival (OS) were analyzed using Kaplan-Meier estimator and Cox proportional hazards model with SAS (v9.4). Results: 704 cases of transformed DLBCL were identified, 535 (76%) from FL and 169 (24%) from MZL. The median TTT (95% CI) was 3.8 years (3.6-4.3). The
NHL-023 SCHOLAR-1 versus ZUMA-1: A Standardized Comparison of Outcomes in Patients (Pts) with Refractory, Aggressive Non-Hodgkin Lymphoma (rNHL) Sattva Neelapu ,1 Frederick Locke,2 Nancy Bartlett,3 Lazaros Lekakis,4 Patrick Reagan,5 David Miklos,6 Caron Jacobson,7 Ira Braunschweig,8 Olalekan Oluwole,9 Tanya Siddiqi,10 Yi Lin,11 Michael Crump,12 John Kuruvilla,12 Eric Van den Neste,13 Brian Link,14 Umar Farooq,14 Lynn Navale,15 Willilam Go,15 Jeffrey Wiezorek,15 Christian Gisselbrecht13
Table 1 Survival Outcomes of DLBCL Transformed from FL and MZL FL/MZL N
TTT
60
334
3.3 (2.8-3.8)
> 60
370
4.4 (3.8-4.7)
Male
370
3.8 (3.3-4.4)
Female
334
4.0 (3.6-4.5)
Age
274
3.9 (3.3-4.6)
III-IV
365
3.8 (3.4-4.4)
Type
N
OS2
< 0.001 8.6 (7.7-10.2)
10.8 (10.0-12.8)
7.0 (4.0-)
468
3.4 (2.1-6.5)
370
4.3 (2.8-)
334
5.1 (3.1-8.2)
262
6.9 (4.0-8.2)
347
3.1 (1.9-6.5)
0.962
0.316 10.8 (10.3-12.9) 10.3 (9.6-11.3)
0.004
0.003
0.010
0.298
FL
535
4.0 (3.7-4.6)
10.9 (10.3-12.8)
262
4.0 (3.4-8.2)
MZL
169
3.6 (2.8-4.0)
8.7 (7.3-10.3)
347
3.1 (1.6-7.0)
Clinical Lymphoma, Myeloma & Leukemia September 2017
P 0.001
236 0.992
10.4 (9.8-12.0) 0.257
I-II
P
13.9 (11.1-) 0.895
Stage
-
DLBCL OS1
0.001
Sex
S362
P
to be combined with other targeted agents for DLBCL to achieve optimal clinical efficacy.
NHL-016 Clinical Characteristics and Outcome of Transformed Diffuse Large B-Cell Lymphoma in the Rituximab Era: A SEER Database Analysis Yucai Wang ,1 Yanru Wang,2 Michael Wang,3 Gita Thanarajasingam,1 Carrie Thompson,1 Grzegorz Nowakowski,1 Thomas Habermann,1 Stephen Ansell,1 Thomas Witzig1 1
Mayo Clinic, Rochester, MN, United States; 2Duke Cancer Institute, Duke University Medical Center, Durham, NC, United States; 3The University of Texas MD Anderson Cancer Center, Houston, TX, United States
Context: Follicular lymphoma (FL) and marginal zone lymphoma (MZL) can transform to diffuse large B-cell lymphoma (DLBCL), with a low annual transformation rate. Historically, patients with transformed disease in the pre-rituximab era had a poor outcome with a median post-transformation survival of less than 2 years. Objective: To analyze the clinical characteristics and outcome of DLBCL transformed from FL or MZL in the rituximab era and to compare the survival outcomes of transformed vs de novo DLBCL. Design: Retrospective study using SEER database (19982013). Setting: Population-based cancer registry data analysis. Patients or Other Participants: DLBCL patients with prior diagnosis of FL or MZL; and age, gender and stage matched de novo DLBCL patients. Interventions: N/A. Main Outcomes Measures: Time to transformation (TTT) and overall survival (OS) were analyzed using Kaplan-Meier estimator and Cox proportional hazards model with SAS (v9.4). Results: 704 cases of transformed DLBCL were identified, 535 (76%) from FL and 169 (24%) from MZL. The median TTT (95% CI) was 3.8 years (3.6-4.3). The
NHL-023 SCHOLAR-1 versus ZUMA-1: A Standardized Comparison of Outcomes in Patients (Pts) with Refractory, Aggressive Non-Hodgkin Lymphoma (rNHL) Sattva Neelapu ,1 Frederick Locke,2 Nancy Bartlett,3 Lazaros Lekakis,4 Patrick Reagan,5 David Miklos,6 Caron Jacobson,7 Ira Braunschweig,8 Olalekan Oluwole,9 Tanya Siddiqi,10 Yi Lin,11 Michael Crump,12 John Kuruvilla,12 Eric Van den Neste,13 Brian Link,14 Umar Farooq,14 Lynn Navale,15 Willilam Go,15 Jeffrey Wiezorek,15 Christian Gisselbrecht13
Table 1 Survival Outcomes of DLBCL Transformed from FL and MZL FL/MZL N
TTT
60
334
3.3 (2.8-3.8)
> 60
370
4.4 (3.8-4.7)
Male
370
3.8 (3.3-4.4)
Female
334
4.0 (3.6-4.5)
Age
274
3.9 (3.3-4.6)
III-IV
365
3.8 (3.4-4.4)
Type
N
OS2
< 0.001 8.6 (7.7-10.2)
10.8 (10.0-12.8)
7.0 (4.0-)
468
3.4 (2.1-6.5)
370
4.3 (2.8-)
334
5.1 (3.1-8.2)
262
6.9 (4.0-8.2)
347
3.1 (1.9-6.5)
0.962
0.316 10.8 (10.3-12.9) 10.3 (9.6-11.3)
0.004
0.003
0.010
0.298
FL
535
4.0 (3.7-4.6)
10.9 (10.3-12.8)
262
4.0 (3.4-8.2)
MZL
169
3.6 (2.8-4.0)
8.7 (7.3-10.3)
347
3.1 (1.6-7.0)
Clinical Lymphoma, Myeloma & Leukemia September 2017
P 0.001
236 0.992
10.4 (9.8-12.0) 0.257
I-II
P
13.9 (11.1-) 0.895
Stage
-
DLBCL OS1
0.001
Sex
S362
P