Diagnosis to Treatment Interval Is the Most Significant Prognostic Factor Compared to Symptoms to Treatment As Well As to Contact to Treatment Intervals in DLBCL Patients

• Published in: Blood 2023-11, Vol.142 (Supplement 1), p.4510-4510
• Main Authors: Vodicka, Prokop, Masar, Michal, Klanova, Magdalena, Benesova, Katerina, Koren, Jan, Klener, Pavel, Blahovcova, Petra, Dlouha, Jitka, Hrabetova, Sarka, Trněný, Marek
• Format: Article
• Language: English
• ISSN: 0006-4971; 1528-0020
• DOI: 10.1182/blood-2023-186467

Background Short interval from diagnosis (i.e., biopsy) to treatment initiation (DTI) is associated with aggressive behavior of lymphomas including diffuse large B-cell lymphoma (DLBCL), and it should be considered as an inclusion criterium in clinical trials to avoid bias given by treatment delay. However, date of biopsy (diagnosis date) could be influenced by other factors. Initial symptoms to treatment interval (STI) as well as interval between the first contact with health care system and treatmet (CTI) could have impact on survival as well as and there is no data analyzing the impact of those intervals. The aim of this analysis was to understand the correlations among these intervals and the impact on survival of patients (pts) in the real-life setting. Methods Altogether 1576 pts with de novo DLBCL or high-grade B-cell lymphoma from Charles University, General Hospital, Prague, Czech Republic, were identified as part of the lymphoma project (NiHiL; NCT03199066). Of them 929 pts were diagnosed between 2010-2021, and 602 (65%) pts who were treated by R-CHOP in this period entered this retrospective analysis. STI ( n = 586), CTI ( n = 535), DTI ( n = 602) were analyzed together with baseline characteristics and survival of the pts (OS, EFS). Results The 602 pts (median age 64 years) were diagnosed with advanced clinical stage (aCS) in 64%, extranodal (EN) involvement ≥ 2 sites in 40%, PS ECOG ≥ 2 in 26%, elevated LDH in 61%, bulky disease ≥ 7.5 cm in 41%, B-symptoms in 42%, and IPI 3-5 in 52%. Median follow-up was 7.5 years (range 0.1-13.2 years). Median STI was 15 weeks (w) (interquartile range, IQR 10-24 w), CTI 9 w (IQR 6-14 w), DTI 32 days - 5 w (IQR 3-7 w, Figure). Significant correlations among the intervals ( P