DLBCL outcomes in Malawi: Effect of HIV and derivation of a simplified prognostic score.

• DOI: 10.1200/jco.2018.36.15_suppl.7565
• Publication Date: 2018-09-05T14:42:41Z
• Authors: Matthew Painschab; Edwards Kasonkanji; Takondwa Zuze; Bongani Kaimila; Tamiwe Tomoka; Bal Dhungel; Maurice Mulenga; Maria Chikasema; Blessings Tewete; Asekanadziwa Mtan...; Sarah Chiyoyola; Wilberforce Mhango; Fred Chimzimu; Coxcilly Kampani; Robert Krysiak; Thomas C. Shea; Nathan Montgomery; Yuri Fedoriw; Satish Gopal
• Keywords: 0303 health sciences; 03 medical and health sciences; 3. Good health

7565 Background: Prognostic factors for diffuse large B-cell lymphoma (DLBCL) in sub-Saharan Africa (SSA) are unknown. We report mature data from one of the first prospective DLBCL cohorts treated under real-world conditions SSA. Methods: Patients ≥18 years with newly diagnosed were enrolled Malawi 2013 to 2017. Participants CHOP chemotherapy, and concurrent antiretroviral therapy (ART) if HIV+. Results: 86 participants mean age 47 (SD 13). 54 (63%) male, 51 (59%) HIV+, whom 34 (67%) on ART at diagnosis. Median CD4 count was 113 cells/mL (IQR 62-227) 25 (49%) had an HIV viral load < 400 copies/mL. HIV+ younger more urban, but otherwise similar HIV-. 10 (12%) died before chemotherapy. received a median 6 cycles 4-6). 28% delayed or reduced toxicity, commonly group, typically neutropenia. No patients lost follow-up follow up 24 months 16-40) still alive administrative censoring. 2-yr overall survival (OS) 38% (95% CI 28-49), 42% 30-53) surviving initiation. For those receiving CHOP, 13/43 (30%) deaths treatment-related, occurred primarily adverse baseline characteristics. In multivariate analyses, only ECOG performance status (PS) ≥2 lactate dehydrogenase (LDH) > 2x upper limit normal (ULN) associated mortality. not OS, patients, being prior diagnosis A simplified prognostic model LDH ULN PS≥2 outperformed traditional age-adjusted IPI. Conclusions: can be successfully SSA outcomes different HIV- although OS worse than resource-rich settings. participants, developing suggesting possible effects immunologic environment tumor biology. utilizing PS may optimal resource-limited settings, where staging is imprecise, requires additional validation.