Abstracts Clinical Lymphoma, Myeloma & Leukemia September 2023 S452 IBCL-328 Follicular Lymphoma: Concentric Study in the Hematology Department of the IBN ROCHD University Hospital Center Hajar Maataoui-Belabbes MD, Meryem Qachouh PhD, Nassima Moufid MD, Amine Benmoussa PhD, Mouna Lamchahab PhD, Mohamed Rachid PhD, Siham Cherkaoui PhD, Nisrine Khoubila PhD, Abdellah Madani PhD Department of Hematology and Pediatric Oncology – Hospital August 20th, Casablanca, Morocco Introduction: Follicular lymphoma (FL) is a systemic neoplasm of the lymphoid tissue displaying germinal center B cell differentiation. It represents 5% of all haematological neoplasms and 20-25%of all new non-Hodgkin lymphoma. Materials and Methods: Descriptive retrospective study carried out at the Hematology Department in Casablanca. From January 2018 to December 2022, 33 patients with newly diagnosed FL. Results: The median age was 54 years [35-80] sex-ratio M/F 1.2. The most common symptomatology was tumor syndrome (30 cases) with B signs in 17 cases. Spinal cord compression, dyspnea and convulsion was respectively inaugural in one patient. Scan PET. The location of the biopsy was lymph node in 27 patients, skin, lacrymal gland, eyelid, maxillary bone, oropharynx and spinal cord in one case, respectively. The histopathological grade was grade 1 in 3 patients, grade 2 in one patient, grade 1 and 2 in 22 cases and 3A in 7 patients. Distribution of stages was: 2 II, 8 III and 23 IV. Within stage IV, the involvement interest bone marrow (9 cases), bone (5 patients), lung (6), liver (4), spinal cord (1), oropharynx (2), tonsils (1) and cutaneous (1). 17 patients had GELF score ≥2 and 22 patients had FLIPI index ≥2. 10 patients required a cytoreductive COP with a good response in 3 patients. wait and see attitude was opted in 2 patients for an average of 7 months before requiring treatment. The protocols used in first line were: RCHOP in 26 patients treated with courses of high-dose methotrexate in 1 case, RCVP in 4 patients (rituximab was not available in one patient at 2 first courses) and R-miniCHOP in 3 patients. Only 5 patients have received rituximab maintenance for 2 years. Complete remission (CR) rate was 79% (26). 9% (3) in partial remission and 12% (4) in therapeutic failure requiring salvage therapy. Only 2 patients have received stem-cell transplantation. 12 patients had a relapse after an average 2.6 years [3month-4.5years] including an early relapse in an autograft patient. Conclusion: Outcomes for FL with R-CHOP are encouraging. Most of our patients have not received rituximab maintenance for lack of means. Refractory and relapsed disease in autograft patients constitutes a therapeutic challenge. Keywords: follicular lymphoma, indolent B cell lymphoma, rituximab, maintenance, stem cell transplantation IBCL-387 Patient Characteristics and Treatment Patterns of US Medicare Fee‑For‑Service Beneficiaries With Waldenström Macroglobulinemia Shayna Sarosiek MD1, Monika Salkar PhD2, Barnabie Agatep MPH3, Anjali Franco MD3, Michelle Pacia PharmD, MBA2, Samuel Crawford PhD2 1Dana-Farber Cancer Institute, Boston, MA, USA. 2AbbVie Inc., North Chicago, IL, USA. 3Inovalon, Bowie, MD, USA Context: Despite its modest efficacy, single-agent rituximab is a commonly prescribed first-line (1L) treatment for symptom control in older adults with Waldenström macroglobulinemia (WM). In clinical trials, 1L single-agent ibrutinib yielded durable clinical outcomes and was well tolerated by older or frail patients. However, real-world evidence differentiating treatment outcomes of ibrutinib and rituximab in older adults with WM remains scant. Objective: To describe patient characteristics and treatment patterns of single-agent ibrutinib or rituximab in the 1L setting among Medicare fee-for-service (FFS) beneficiaries. Design, Patients and Outcomes: Medicare FFS medical and pharmacy claims data were used to identify patients newly diagnosed with WM who received guideline-referenced treatments between January 1, 2014, and December 31, 2019. Continuous enrollment in Medicare for 12 months before and after initiating 1L treatment was required. Demographics, comorbidity profiles, and time to next treatment (TTNT) were analyzed. TTNT was defined as the interval between 1L treatment initiation and either start of the next treatment or the date of death prior to next treatment. Next treatment included any change in, or addition to, treatment >90 days after 1L treatment initiation. Cox proportional hazards regression models were used to assess demographic, clinical, and treatment factors associated with switching to the next treatment. Results: Among patients initiating rituximab (n=1871) or ibrutinib (n=783), the majority were men (50.6% and 58.2%); mean (SD) ages were 77.2 (7.7) years and 77.2 (7.6) years and mean (SD) Deyo-Charlson Comorbidity Indices were 4.5 (2.6) and 4.6 (2.7). Common baseline comorbidities included hypertension (rituximab, 72.3%; ibrutinib, 67.8%), other cardiovascular disease (32.5%; 30.8%), and atrial fibrillation (16.9%; 17.5%). Within 6 and 12 months of initiating 1L treatment, more patients receiving rituximab versus ibrutinib moved to the next treatment (6 months, 18.0% vs 12.6%; P<0.001; 12 months, 30.0% vs 23.6%; P<0.001). After controlling for baseline characteristics, patients treated with ibrutinib were 23% less likely to move to next treatment than patients treated with rituximab (P=0.003). Conclusion: This real-world evidence builds on existing clinical observations and demonstrates a significantly longer TTNT among older adults with WM initiating 1L single-agent ibrutinib, compared with those initiating rituximab. Funding: Pharmacyclics LLC, an AbbVie Company. Keywords: ICBL, Waldenström macroglobulinemia, treatment patterns, time to next treatment, ibrutinib, rituximab
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