Abstract 271P
Background
High grade B cell lymphomas (HGBCL) are aggressive lymphomas, grouped into two entities according to whether or not they express double hit/double expresser phenotype. Entity without double hit/expresser phenotype is termed as HGBCL NOS. Best therapeutic approach to patients with HGBCL NOS is not known; treated with either regimens ideal for DLBCL or with more intensive Burkitt’s like regimens.
Methods
Hospital records of patients diagnosed with HGBCL NOS were retrieved. 34 patients had been non randomly assigned to receive CHOP like regimens (CHOP [20], COP [2], CHOP+HD MTX [5]) or dose adjusted (DA) EPOCH [7] with or without Rituximab[13]. Response rate (RR) to chemoimmunotherapy, toxicity profiles, PFS at 20 months of follow up and OS were noted.
Results
76.4 %(26) were diagnosed with advanced stage. 76.4%(26) had extra-nodal involvement. overall RR to first line therapy was 100%( CR = 58.8%, PR = 29.4%, SD = 11.8%). 48.1% CR and 37.0% PR in the CHOP like regimen arm and 100% CR rate in patients receiving DAEPOCH. At 20 months follow up, the mean and median PFS was 14.8 months and 11 months. DAEPOCH was associated with highest mean and median PFS (23.7 and 30 months) and same for CHOP were (10.31 and 9 months) at 20months of follow up(p = 0.039). Median OS not reached at 20 months of follow up. Use of Rituximab was associated with improved median PFS (30m vs 10m; p = 0.038) at 20 months, in univariate analysis. On an average 1.54 episodes of grade 3-4 neutropenia and 0.65 episodes of febrile neutropenia occurred per patient. Corresponding values for DAEPOCH and CHOP like regimens were (3.7 , 1.5) and ( 0.92, 0.40). 2(5.88%)cases had treatment related death, one each in DAEPOCH(14.2%) and CHOP like regimen arm (3.7%) arm. 21(61.76%) patients relapsed at one year.
Conclusions
Regimens like CHOP or DAEPOCH with Rituximab has high response rates but substantial proportion of patients may relapse. Grade 3-4 neutropenia occurs more frequently with DAEPOCH than CHOP, but treatment related mortality is low for both the regimens. Good PS patients do tolerate intensive regimens. Intensive regimens may be associated with longer PFS that may lead to longer OS.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
304P - Survival outcomes and survival predictors in recurrent and metastatic head and neck squamous cell cancer (R/M-HNSCC) patients treated with chemotherapy (CT) plus cetuximab as first-line therapy in a real-world study
Presenter: Filipa Pontes
Session: Poster display session
Resources:
Abstract
305P - A retrospective study to evaluate patient characteristics for recurrent head and neck cancer after definitive treatment
Presenter: Tetsuro Wakasugi
Session: Poster display session
Resources:
Abstract
306P - Efficacy and safety of apatinib in heavily pretreated metastatic adenocarcinoma of the head and neck
Presenter: Lin Gui
Session: Poster display session
Resources:
Abstract
307P - Lacrimal gland tumours: Clinical and epidemiological patterns in the United States
Presenter: Mahmoud KhalafAllah
Session: Poster display session
Resources:
Abstract
308P - Dental prophylaxis and 5-fluorouracil related oral mucositis in head and neck cancer patients: A population-based cohort study
Presenter: Yi-Fang Huang
Session: Poster display session
Resources:
Abstract
309P - Evaluation of a pharmacist-led opioid de-escalation (PLODE) program after chemoradiotherapy completion in head and neck cancer patients
Presenter: Ai Horinouchi
Session: Poster display session
Resources:
Abstract
310P - Laser and PDT for the oral leukoplakia
Presenter: Sadykov Rasul
Session: Poster display session
Resources:
Abstract
311P - Incidence of thyroid carcinoma in the Philippines: A retrospective study from a tertiary university hospital
Presenter: Priscilla Caguioa
Session: Poster display session
Resources:
Abstract
312P - Oral health disparities among privileged and underprivileged tribes of south India - A study on precancerous oral lesions prevalence
Presenter: Shanavas Palliyal
Session: Poster display session
Resources:
Abstract
313P - Immunotherapy application for advanced cancers: One institution experiences since 2016 to 2019
Presenter: Jo Pai Chen
Session: Poster display session
Resources:
Abstract