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2960 Follicular Lymphoma in Latin America: Real-World Experience from 763 Patients

Program: Oral and Poster Abstracts
Session: 623. Mantle Cell, Follicular, and Other Indolent B-Cell Lymphoma—Clinical Studies: Poster III
Hematology Disease Topics & Pathways:
Follicular Lymphoma, Adult, Diseases, Therapies, Combinations, Non-Hodgkin Lymphoma, B-Cell Lymphoma, Cell Lineage, Lymphoid Malignancies, Study Population, Clinically relevant
Monday, December 7, 2020, 7:00 AM-3:30 PM

Maria Alejandra Torres Viera, MD1,2*, Brady E Beltran, MD3,4*, Luis Villela Villela, MD, MC5,6*, Denisse A. Castro, MD7, Victoria Otero, MD8*, Lorena Fiad, MD9*, Camila Peña, MD10, Henry Idrobo, MD11,12,13,14*, Myrna Candelaria, MD, PharmD15, Alana Von Glasenapp, MD16*, Ivan Perdomo, MD17*, Maria Virginia Prates, MD9, Sally Rose Paredes, MD18*, Fernando Pérez-Jacobo, MD19, Ana Ramirez-Ibarguen, MD20*, Juan Alejandro Ospina Idarraga21,22*, Maria Elena Cabrera, MD23*, Claudia Gajardo, MD24*, Macarena Alejandra Roa Salinas25*, Catalina Díaz, MD26*, Laura Silva Idárraga, MD27*, Humberto Martínez Cordero, MD28*, Melani Otañez, MD29*, Fabiola Valvert, MD30, Efreen Montaño Figueroa, MD, PhD31*, Marcos Di Stefano, MD32,33*, Rosio Baena, MD34,35*, Juan Antonio Choque, MD36*, Virginia Abello, MD37*, Cristaldo Nancy, MD38*, Guilherme Fleury Perini39*, Luis E Malpica Castillo, MD40, Eduardo Sotomayor, MD41 and Jorge J. Castillo, MD42,43

1Universidad Central de Venezuela, Caracas, Venezuela (Bolivarian Republic of)
2Clinica Santa Sofia, Caracas, Miranda, Venezuela
3Departamento de Oncología y Radioterapia,, Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru
44Centro de Investigación de Medicina de Precisión, Universidad de San Martin de Porres, Lima, Peru
5Campus Hermosillo, Universidad del Valle de Mexico, Son, Mexico
61) Hospital Dr. Ignacio Chavez, ISSSTESON,Hermosillo,Son,Mex, Hermosillo, SO, Mexico
7Centro de Investigación de Medicina de Precisión, Universidad de San Martin de Porres, Lima, Peru
8Sección Hematología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
9Hematología, Hospital Italiano de La Plata, La Plata, Argentina
10Hematology Department, Hospital Del Salvador, Santiago, Chile
11Facultad de Medicina., Universidad Del Valle, Cali, Colombia
12Hospital Universitario del Valle, Cali, Colombia
13Facultad de Medicina., Universidad Libre, Cali, Colombia
14Hematología Oncología, Grupo Ospedale, Cali, Colombia
15Research Division, Instituto Nacional de Cancerología, Mexico City, Mexico
16Department of Hematology, Instituto de Prevision Social, Asuncion, Paraguay
17Clínica Los Nogales, Bogota, Colombia
18Departamento de Oncología y Radioterapia, Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru
19Hematology Department, Hospital Central Norte Petróleos Mexicanos, Ciudad DE Mexico, Cdmx, Mexico
20Instituto Nacional de Cancerologia, Mexico, Mexico
21El Bosque los Cobos Medical Center, Bogotá, Colombia
22Instituto Nacional de Cancerología, Bogotá, Colombia
23Hematology Department, Hospital del Salvador, Santiago, Chile
24Hospital del Salvador, Santiago, Chile
25Hematología, Hospital Del Salvador, Santiago, Chile
26Hematología, Hospital del Salvador, Santiago, Chile
27Universidad Libre Seccional de Cal, Cali, Colombia
28Instituto Nacional de Cancerologia, Bogota, Colombia
29Hospital General del Estado de Sonora, Hermosillo, Son., Mexico
30Instituto De Cancerología y Hospital Dr. Bernardo Del Valle (INCAN), Ciudad de Guatemala, Guatemala
31Hospital General de Mexico, CDMX, Mexico
32Hospital Solom Espinosa Ayala, Solca-Quito, Ecuador
33Hospital de los Valles de Quito, Universidad San Francisco de Quito, Quito, Ecuador
34Clínica Los Olivos, Cochabamba, Bolivia (Plurinational State of)
35Instituto Oncológico Nacional Caja Petrolera de Salud, Cochabamba, Bolivia
36Servicio de Hematologia, Caja Nacional de Salud - Hospital de Especialidades Materno Infantil La Paz, La Paz, Bolivia (Plurinational State of)
37Asociación Colombiana de Hematología y Oncología (ACHO), Bogotá, Colombia
38Hospital Italiano de Buenos Aires (HIBA), Buenos Aires, Argentina
39Hospital Israelita Albert Einstein, São Paulo, Brazil
40Department of Lymphoma and Myeloma, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
41George Washington University Cancer Center, Washington, DC
42Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
43Bing Center for Waldenström Macroglobulinemia, Dana Farber Cancer Institute, Boston, MA

Introduction: Follicular lymphoma (FL) is the most common indolent non-Hodgkin lymphoma subtype seen in Western countries. However, data on FL from Latin America (LATAM) are scarce. We aimed at better understanding the clinical features, treatment patterns and outcomes of patients with FL from LATAM.

Methods: This is a retrospective study that included all consecutive patients with a pathological diagnosis of FL at 18 participating centers from 12 LATAM countries. All cases were reviewed by specialized pathologists at their respective participating centers. Pertinent clinical, pathological and treatment data were collected. Responses were assessed per the Lugano criteria. Time to first treatment, progression-free survival after first treatment (PFS1) and overall survival (OS) were estimated using the Kaplan-Meier method.

Results: A total of 763 patients were included in this analysis. On clinical features, 51% of patients were ≥60 years, 46% were male, 29% had extranodal involvement, 27% had bulky disease (≥6 cm in diameter), 68% had stage III/IV disease, 21% had hemoglobin <12 g/dl, 12% had serum albumin <3 g/dl, 34% had elevated serum LDH and 24% had B2-microglobulin ≥3,5 mg/l. Low, intermediate and high-risk FLIPI was seen in 43%, 33% and 23% of patients, respectively. Low, intermediate and high-risk FLIPI2 was seen in 18%, 64% and 17% of patients, respectively. The median time to first treatment was 0.08 years (95% CI 0.08-0.09), and 88% of patients started therapy within 1 year of diagnosis. Of the 647 treated patients, 70% received CHOP ± rituximab (R), 16% CVP ± R, 6% bendamustine ± R, 4% R alone and 4% other treatments. Response data were available in 628 patients with complete response in 72%, partial response in 21% and no response in 7%, for an overall response rate of 93%. The median PFS1 was 10.5 years (95% CI 7.3-not reached; Figure), and 74 patients (12%) had disease progression within 24 months of first treatment initiation (POD24). The median OS was 21.1 years (95% CI 13-not reached; Figure). Patients with low, intermediate and high FLIPI had median OS not reached, 21.1 and 9.5 years, respectively (p<0.001). Patients with low, intermediate and high FLIPI2 had median OS not reached, 21.1 and 6.8 years, respectively (p<0.001). Patients who had and did not have POD24 had median OS of 7.3 years (95% CI 4.8-not reached) and 21.1 years (95% CI 13-not reached), respectively (p<0.001).

Conclusion: This large, real world evidence LATAM cohort of 763 patients with FL showed a higher than expected female incidence as well as higher rates of extranodal and bulky disease than previously reported in Western cohorts. Chemoimmunotherapy is the standard approach to FL patients in LATAM, which is associated with high rates of response and highly encouraging PFS and OS rates. Our study validates the prognostic value of FLIPI, FLIPI2 and POD24.

Disclosures: Villela: Roche: Other: advisory board, Speakers Bureau; amgen: Speakers Bureau. Peña: Amgen: Speakers Bureau; BindingSite: Research Funding; Janssen: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Sandoz: Membership on an entity's Board of Directors or advisory committees; Roche: Membership on an entity's Board of Directors or advisory committees; Abbvie: Membership on an entity's Board of Directors or advisory committees. Idrobo: Takeda: Honoraria, Speakers Bureau; Amgen: Honoraria, Speakers Bureau; Tecnofarma: Honoraria, Speakers Bureau; Janssen: Honoraria, Speakers Bureau; Abbvie: Honoraria, Speakers Bureau. Abello: Dr. Reddy's: Consultancy, Research Funding; Takeda: Honoraria, Research Funding; Novartis: Consultancy, Honoraria; Amgen: Consultancy, Research Funding; Abbvie: Consultancy, Research Funding. Perini: AbbVie, Janssen: Speakers Bureau; Janssen, Takeda: Honoraria. Castillo: Abbvie: Research Funding; TG Therapeutics: Research Funding; Janssen: Consultancy, Research Funding; Kymera: Consultancy; Pharmacyclics: Consultancy, Research Funding; Beigene: Consultancy, Research Funding.

*signifies non-member of ASH