Early progression as a predictor of survival in hodgkin and b-cell non hodgkin lymphoma, in the real world: the Ukrainian lymphoma registry-based study

Abstract

Background: Lymphoma, being a relatively rare disease, benefits greatly from national-level data collection. It is important to study results of lymphoma treatment in different countries and with different healthcare systems to ensure that there is contemporary, geographically relevant data on lymphoma. Association of progression of disease at 24 months (POD 24) with overall survival (OS) has been confirmed in several types of lymphomas. Methods:The analysis refers to all newly diagnosed lymphoma cases identified at the National Cancer Institute (NCI) of Kyiv and seven other Ukrainian centers from September 2019 to December 2023. The diagnosis was classified according to WHO 2016 criteria, and registration was conducted in a secure, specialized database. The study received approval from the NCI Institutional Review Board. POD 24 was calculated for patients with the more frequent histology and adequate follow-up. Survival analysis distinguished between early progressors and those without early progression, adjusting OS calculations based on the timing of progression to refine outcome assessments. Results: A total of 1074 patients with newly diagnosed lymphoma were prospectively registered in ULR. The male-to-female ratio (M/F) for the entire population was 0.94, and the median age was 49 years (range 18-100). B-cell non-Hodgkin lymphoma represents the majority, comprising 740 cases (68.9%). Hodgkin lymphoma (HL) accounts for 296 cases (27.5%), predominantly represented by the Nodular sclerosis classical subtype in 207 cases (70%). The most frequent subtypes among B-NHL was Diffuse large B-cell lymphoma (DLBCL) with 259 cases (35%). In HL patients 3-year OS was 82% and 98% for patients with or without POD24 (HR 5,7 (CI95% 2,1-15,3), p=0,00042). In patients with DLBCL POD24 was 42% and 80%, with a HR 8,8 (CI95% 2,1-15,4, p = 0.00073). In Primary mediastinal large B-cell lymphoma patients 3-year OS was 25% and 88% for patients with or without POD24 (HR 8,8 (CI95% 2-38,4), p= 0.00073). In patients with Primary CNS lymphoma POD24 was 24% and 86% with a HR 42 (CI95% 4,4-399), p<0,0001. (Figure 1).