Diffuse large B-cell lymphoma: A single-institution experience of patient outcomes.

Authors

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Ryan James Chan

University of Toronto, Toronto, ON, Canada

Ryan James Chan, Rasna Gupta, Sindu Mary Kanjeekal, Mohammed Jarrar, Amin Kay, John Mathews, Indryas Lemma Woldie, Caroline M. Hamm

Organizations

University of Toronto, Toronto, ON, Canada, Barbara Ann Karmanos Cancer Inst, Detroit, MI, Canada, Windsor Regional Cancer Centre, Windsor, ON, Canada, Oncology Department, King Abdulaziz Medical City, Riyadh, Saudi Arabia, Karmanos Cancer Ctr Wayne State Univ, Detroit, MI

Research Funding

No funding sources reported

Background: The Windsor Regional Cancer Program (WRCP) was determined to have consistently been a top performer in time to treatment of diffuse large B cell lymphoma in this Canadian province (http://www.csqi.on.ca/by_type_of_cancer/lymphoma/lymphoma_treatment/). We endeavored to determine whether faster time to diagnosis and treatment for diffuse large B-cell lymphoma (DLBCL) influenced the IPI score (International Prognostic Score), thereby predicting an improved clinical outcome in these presenting patients. Methods: The WRCP services a catchment area of 650,000 people. A retrospective chart review was conducted for patients diagnosed with DLBCL at the Windsor Regional Cancer Program (WRCP) between 2006-2012. Information collected included the five factors for scoring by the International Prognostic Index (IPI) – age, performance status, LDH, stage, and number of extranodal sites – chemotherapy regimen, relapses, existence of second malignancies, cause of death, and dates of diagnosis, last follow-up, and death. We analyzed the relationship between prognostic factors and these clinical outcomes, and also compared the IPI scores for this cohort of patients against a similar population in another Canadian province, British Columbia. Results: It is established that compared to other cancer centres in Ontario, the WRCP is consistently reporting a shorter diagnosis to treatment metric when compared to their counterparts in Ontario, Canada. When compared to historical Canadian data, presenting IPI scores for DLBCL patients were lower on average for patients treated at the WRCP than those reported in British Columbia, Canada by Sehn et al. [Sehn, L. H., et al. (2007). The revised International Prognostic Index is a better predictor of outcome than the standard IPI for patients with diffuse large B-cell lymphoma treated with R-CHOP. Blood, 109(5), 1857-1861.]. Conclusions: A lower presenting IPI score is known to be correlated improved lymphoma related outcome. With attention to the metric of diagnosis to treatment < 30 days for diffuse large B cell lymphoma, we expect an improved lymphoma related outcome for our patients. We recommend ongoing attention to this metric, in order to improve outcomes for our patients.

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Abstract Details

Meeting

2016 ASCO Quality Care Symposium

Session Type

Poster Session

Session Title

Poster Session B: Science of Quality

Track

Cost, Value, and Policy in Quality,Practice of Quality,Science of Quality

Sub Track

Quality Measurement

Citation

J Clin Oncol 34, 2016 (suppl 7S; abstr 271)

DOI

10.1200/jco.2016.34.7_suppl.271

Abstract #

271

Poster Bd #

K11

Abstract Disclosures