Session: 627. Aggressive Lymphomas: Clinical and Epidemiological: Poster I
Hematology Disease Topics & Pathways:
Research, adult, epidemiology, elderly, Clinical Research, real-world evidence, young adult , Study Population, Human
Methods. This was a retrospective analyses of patients with de novo DLBCLtreated with curative intent between 2010 and 2018. The classic 5 international prognostic index variables [age, ECOG, Extranodal (EN) involvement, Lactate dehydrogenase (LDH), and advanced stage] and low serum albumin defined as ≤3.5mg/dL(divided in low, 3.4-2.5 mg/dL, and very low, ≤2.4 mg/dL), as previously described by our group (Villela,2018&2019). We also calculated the NLR considering an adverse prognostic factor >4, as previously published by us (Beltran&Villela,2020). The HALP score was calculated using the following formula: hemoglobin(g/L) x albumin (g/L) x absolute lymphocyte count (k/μL) divided by platelets (k/μL). The ROC method was used to calculate the HALP cut-off. Demographic characteristics are reported using descriptive statistics. Cox proportional-hazard regression model was used to evaluate parameters associated with OS, and survival curves were estimated with the Kaplan-Meier (KM) method.
Outcomes. 1407 patients were included, who were treated with standard RCHOP (n=1112,79%), RminiCHOP (n=93,7%), REPOCH (n=111,8%), and CHOP (n=91,6%). The median follow-up was 36 months (IQR: 7 to 56). NLR >4 was observed in 18.5%. The median HALP score was 24 (IQR, 12 to 40), and the cut-off of ≤13 (AUC 0.58;95%CI 0.56 to 0.61; p<0.0001) was considered an adverse prognostic factor, which was observed in 451 patients (32.7%). Female sex, ECOG >1, EN >1. high LDH, advance stage, low and very low albumin, and NLR>4 were associated with HALP≤13, but age was not (Table 1). Patients with HALP ≤13 had a lower 3-years OS rate than HALP>13 (48% vs. 66%, respectively; p<0.001). Table 2 shows the univariate & multivariate analysis of the variables with independent influence on OS, including HALP & NLR. In multivariate analysis, HALP and EN involvement were left out of the model ( Harrell´s C-Index, 0.73;95%CI 0.69 to 0.76).
Conclusion: NLR>4, but not HALP ≤13, could prognosticate inferior OS in LATAM patients with DLBCL treated with curative intent. The adverse prognostic value of NLR>4 should be validated prospectively in other cohort of DLBCL patients.
Disclosures: Villela Martinez: Sanofi: Speakers Bureau; TEVA: Speakers Bureau; roche: Speakers Bureau; Merck Sharp and Dome: Speakers Bureau; astra zeneca: Speakers Bureau. Ramirez: roche: Speakers Bureau; merck sharp and dome: Speakers Bureau. Quintero: Takeda: Speakers Bureau; astra zeneca: Speakers Bureau; roche: Speakers Bureau; Merck Sharp and dome: Speakers Bureau. Perini: Abbvie: Consultancy, Speakers Bureau; Lilly: Consultancy, Speakers Bureau; MSD: Consultancy, Speakers Bureau; Takeda: Consultancy, Speakers Bureau; Janssen: Consultancy, Speakers Bureau; Merck: Membership on an entity's Board of Directors or advisory committees, Speakers Bureau; Astra zeneca: Consultancy, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau. Gomez-Almaguer: AMGEN: Consultancy, Honoraria; Janssen: Consultancy, Honoraria; Novartis: Honoraria; AbbVie: Consultancy, Honoraria. Castillo: AstraZeneca: Consultancy, Research Funding; Loxo: Consultancy, Research Funding; Cellectar: Consultancy, Research Funding; BeiGene: Consultancy, Research Funding; Abbvie: Consultancy, Research Funding; Pharmacyclics: Consultancy, Research Funding; Mustang Bio: Consultancy; Kite: Consultancy.
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