bluuebunny/crossref_metadata_2025_split huggingface dataset:
COVID-19 pandemic experience in patients with Hodgkin lymphoma.
Authors: Prischak Sara E. , Ballard Hatcher J. , Duca Adam N. , Gerson James M. , Landsburg Daniel J , Barta Stefan K. , Svoboda Jakub 
Published: June 2022

e19534 Background: Patients (pts) with Hodgkin lymphoma (HL) may be at an increased risk from COVID-19-related complications due to immunosuppression and common therapies with pulmonary toxicities (e.g. bleomycin, radiation). Additionally, they may experience unexpected adverse events (AEs) from the novel SARS-CoV-2 vaccines due to the intrinsic abnormalities in cellular immunity. Exploring their perspective on the COVID-19 pandemic and subjective AEs from the novel vaccines may ultimately allow providers to develop improved services based on needs of this specific population. Methods: We conducted a single-institution, questionnaire-based study in pts treated after 1/1/2015, for diagnosis of HL. Pts were identified through the electronic medical records at our institution. After signing an informed consent, pts answered 19 questions designed to reflect on their COVID-19 pandemic experience. An additional section aimed to determine the percentage of pts with a local or systemic AEs within 7 days of novel SARS-CoV-2 vaccine dose. Results: We enrolled 30 pts with median age 28.5 years (18-66); 16 (53%) were male, and 26 (87%) were on active HL therapy. With data cutoff 1/28/2022, 27 pts (90%) completed the questionnaire. A total of 8 (27%) patients had COVID-19 infection with 75% of those occurring after the vaccination. None required hospitalization and none reported residual pulmonary issues. Eighteen (67%) had a member of their household test positive for COVID-19. Most pts (67%) did not require cancellation of their appointments due to COVID-19-related issues during the pandemic. 85% of pts participated in at least 1 telehealth medical appointment and the majority (72%) were satisfied with their telehealth experience for cancer care. A total of 24 (80%) pts received the novel SARS-CoV-2 vaccines (58% had Pfizer-BioNTech BNT162b2, 38% Moderna mRNA-1273, 4% Ad26.COV2.S) and 23 pts completed the AE section of the questionnaire. The vaccines were generally well-tolerated. Six pts (26%) reported at least one grade 3 AE, but none had grade 4 local or systemic AEs. The most common AE was pain at injection site (65% after dose 1, 55% after dose 2, 69% after dose 3). AEs that occurred in over 25% of pts during any of the injections included redness/swelling/pain at the injection site, fatigue, headache, muscle pain, and fever. Of 23 eligible pts, 13 (57%) received 3rd dose of the vaccine. No unexpected toxicities or autoimmune issues were noted by participants in this study following vaccination with a median follow up of 10 months after the 1st vaccine dose. Conclusions: Based on responses from our study, HL pts adjusted to the challenges of the COVID-19 pandemic with minimal disruptions to their cancer care, showed positive attitudes toward telehealth, and appear without any unexpected toxicities from the novel vaccines.
Epidemiological characteristics and cause-specific survival analysis of plasmablastic lymphoma (PBL) using the SEER database.
Authors: Gor Dhairya , Gwalani Pranav , Gor Rajvi , Wiseman Kyle , Levitt Michael J. , Sen Shuvendu 
Published: June 2022

e19546 Background: Plasmablastic lymphoma (PBL), a variant of diffuse large B-cell lymphoma, is a rare and aggressive malignancy. Minimal guidelines exist for its diagnosis and standard of care. Hence, we studied the epidemiological characteristics and survival variables of PBL patients by using the SEER 20 database. Methods: A total of 229 cases of PBL (WHO ICD-O-3 codes 9735/3) were identified between 2000 and 2015, after excluding 66 cases with unknown survival time or no microscopic confirmation. The epidemiological characteristics and the survival variables included were age, gender, ethnicity, Ann Arbor stage, B-symptoms, and site. The overall 5-year survival (OS), cause-specific 5-year survival (CSS), and cause-specific survival plots across different strata were plotted using the Kaplan Meier Method. The analysis was done using the Cox proportional hazard regression model (p < 0.05). Results: The incidence of PBL was 0.03 per 100,000 cases. It was more common in adults less than 60 years (61.57%), males (79.04%), and White ethnicity (72.49 %). There were more cases of patients with advanced Ann Arbor stages (3 or 4) PBL (52.84%), although some patients (5.68%) had unknown staging. There were 55.02% of extranodal cases, and 28.38% of patients had B-symptoms. The OS was 36.55%, and the CSS was 46.5%. CSS did not differ significantly based on age, race, or gender. However, the absence of B-symptoms was associated with better CSS (HR: 0.654, 95% CI: 0.455-0.941, p: 0.022). Nodal involvement (HR: 1.553, 95% CI: 1.135-2.124, p: 0.006) and advanced stages 3 or 4 (HR: 1.414, 95% CI: 1.018-1.962, p: 0.038) were also linked to a poor CSS. Conclusions: PBL patients with a primary nodal involvement and advanced staging (3 or 4) had poor CSS, and the absence of B-symptoms was associated with a better outcome. Age, gender, and ethnicity had no discernible effects on survival. We did not include therapeutic options in our study, and hence, further studies analyzing the impact of treatment options on PBL survival can be conducted.[Table: see text]
Outcomes and prognostic assessment of post-transplant lymphoproliferative disorder.
Authors: Shaikh Hira , Omer Zulfa , Jandarov Roman , Delman Aaron , Latif Tahir 
Published: June 2022

e19548 Background: Post-transplant lymphoproliferative disorder (PTLD) is the most common malignancy after solid organ transplantation (SOT) in adults, apart from skin cancer. It is a serious and potentially fatal complication of chronic immunosuppression in SOT recipients. Methods: Institutional electronic health record (EHR), Epic was queried for PTLD patients evaluated at the University of Cincinnati Cancer Center 1991 - 2020. Relationships between clinical characteristics and time from diagnosis to death were assessed using t-test and ANOVA, with SAS 9.4. Overall survival (OS) was evaluated by Kaplan Meier estimates, from the date of PTLD diagnosis to death or last follow-up. Results: Sixty patients were identified with PTLD in the study period. A higher proportion of males (65%) and Caucasians (92%) was noted. The most common type of transplants were kidney (40%) and liver (32%). The median time from transplant to PTLD was 7.3 y and the median age at diagnosis was 54.5 y. The majority had monomorphic PTLD (60%) and presented as Stage IV (25%) or with end-organ dysfunction (67%). Most had extranodal involvement (67%), with GI (23%) being the most frequently involved site. EBV was positive in 32%. Immunosuppression was changed in 75% of the patients and most received rituximab-chemotherapy (55%), with two-thirds achieving a response. The 2-year OS was 55%. Gender (males 44%, females 14%; p = 0.0216), transplant type (lung 67%, liver 53%, kidney 21%, kidney-pancreas 0%; p = 0.0183) and treatment response (CR 20%, PR 29%, no response 100%; p = 0.0003) were significantly associated with mortality. Median time from PTLD diagnosis to death was 5.2 mo, being significantly shorter in liver transplant recipients (p < 0.0001), those managed by observation only (p < 0.0001) or with end-organ dysfunction at diagnosis (0.0072). A similar trend was noted in males, non-Caucasians, HLA-mismatch, and polymorphic PTLD, but this was statistically nonsignificant. Conclusions: This investigation highlights the prognostic risk factors of PTLD, that could be helpful in the management of the patients and guiding future research.[Table: see text]
Long-term survival projections of loncastuximab tesirine-treated patients in relapsed or refractory (R/R) diffuse large B-cell lymphoma (DLBCL).
Authors: Hamadani Mehdi , Graham Christopher N. , Liao Laura , Zhang Katherine H , Strat Hannah , Ungar David , Ai Weiyun Z. , Chen Lei , Carlo-Stella Carmelo 
Published: June 2022

e19551 Background: Loncastuximab tesirine (loncastuximab tesirine-lpyl; Lonca) is an FDA approved CD19-directed antibody-drug conjugate for R/R DLBCL. From the LOTIS-2 trial primary data cut (April 6, 2020), overall response rate was 48.3% and median overall survival (OS) was 9.9 months. The OS Kaplan-Meier (KM) plot displayed a survival plateau suggesting the presence of long-term survivors (LTS). Survival analyses were conducted on a more mature data cut (March 1, 2021; median follow-up = 1.7 years, follow-up completeness at median = 81%) to estimate the percentage of LTS and expected lifetime survival (mean OS) for lonca-treated patients. Methods: Consistent with studies of other R/R DLBCL treatments, identified through a literature review, parametric and mixture cure models were fit utilizing multiple distributions. Flexible cubic spline (hazard scale 1-3 knots) and non-mixture cure analyses were also conducted. Age- and gender-matched United States life table hazards were used in projections for LTS and to ensure modeled hazards were not less than the general population. Best-fit models were determined through fit statistics, KM and fitted curve overlays, and clinical plausibility. The best-fit model from each method was a candidate for overall best fit. A hybrid model following the best-fit parametric/spline model to a defined time point and switching to general population mortality was also constructed. Results: Mixture and non-mixture cure models fit best (individual best fits gamma and Weibull, respectively). Parametric and spline models (individual best fits log-normal and 2 knot models, respectively) did not fit the observed data well nor fit the clinical expectation of long-term survival. Due to better fit, spline models were used in the hybrid model. LTS from the mixture cure and non-mixture cure models were 24-26%. Mixture cure, non-mixture cure, and hybrid model with a 2-year switch point were consistent in survival predictions (6.11-6.23 years). In a sensitivity analysis with 3-year switch point in the hybrid model, the estimated survival was shorter due to the switch point being below the observed survival plateau. Table presents full survival results and fit statistics. Conclusions: The observed survival plateau suggests lonca-treated patients may include LTS. Mixture cure, non-mixture cure, and hybrid models fit the trial data well and align on survival projections (6.11-6.23 years). Additional follow-up may help refine the switch point of the hybrid model and confirm presence of LTS.[Table: see text]
Use of circulating tumor DNA in newly diagnosed DLBCL patients.
Authors: Tomassetti Sarah , Samara Yazeed , LaBarbera Katie , Qing Xin , Rathore Richa , Aleshin Alexey , McPhaul Laron 
Published: June 2022

e19552 Background: Diffuse large B-cell lymphoma (DLBCL) is the most common type of lymphoma. With upfront treatment, 40% of patients relapse. Currently, treatment response and surveillance are monitored using positron emission tomography/computerized tomography (PET/CT). However, no study to date has shown significant improvement in outcomes in lymphoma patients using standard radiographic and clinical surveillance. Most often, relapses likely occur from minimal residual disease (MRD) below the detection of imaging. Thus, a subclinical biomarker to better monitor treatment response and surveillance is needed. Circulating tumor DNA (ctDNA) has emerged as a sensitive biomarker for detecting MRD. Here, we aimed to evaluate the utility of ctDNA as a biomarker for monitoring treatment response and surveillance in patients with lymphoma. Methods: ctDNA analysis using a personalized, tumor-informed assay (Signatera bespoke mPCR NGS assay) was performed on blood samples collected from 15 patients with newly diagnosed DLBCL who presented to Harbor-UCLA Medical Center in 2021. Blood samples were collected at diagnosis, prior to each cycle of therapy, and every 3 months thereafter for surveillance. The primary endpoint was the rate of ctDNA clearance during treatment and its correlation with radiological imaging. Secondary endpoints included ctDNA positivity rate during surveillance and its correlation with radiological imaging. Additional data collected included patient demographics, lymphoma characteristics, and treatment regimen. Results: Of the 15 patients included in this cohort, the median age was 54 years and the percentage of patients with stage 1, 2, 3, and 4 disease was 7%, 20%, 7% and 67%, respectively. A total of 7% had high risk IPI scores. Within this cohort, 80% received RCHOP and 20% received daREPOCH. ctDNA was detected in 93.3% (14/15) of patients at diagnosis, with levels ranging from 2-3,607 mean tumor molecules (MTM)/mL of plasm. Of the ctDNA+ patients, 6 (40%) patients had a complete response to initial therapy as assessed by post-treatment imaging. Longitudinal assessment of ctDNA after each cycle of therapy revealed concordance with radiological findings, where 2/6 cleared ctDNA after cycle 1, 4/6 cleared ctDNA after cycle 2, 5/6 cleared ctDNA after cycle 3, and 6/6 cleared ctDNA after cycle 4 of treatment. One patient had undetectable ctDNA after cycle 4, but had a Deauville score of 4 on post-treatment PET/CT and was referred to radiation. Of the 3 patients who remained ctDNA positive on longitudinal testing, all were confirmed to have primary refractory disease by imaging. Of the remaining patients, 1 patient died after daREPOCH cycle 1 and 3 patients are undergoing initial therapy. Conclusions: ctDNA may serve as an important biomarker to assess response to treatment and for surveillance in DLBCL patients. Further studies evaluating ctDNA use in the clinical setting are needed before its application in routine practice.
Pharmacokinetics (PK) and pharmacodynamics (PD) in First-MIND: A phase Ib, open-label, randomized study of tafasitamab (tafa) ± lenalidomide (LEN) in addition to R-CHOP in patients (pts) with newly diagnosed diffuse large B-cell lymphoma (DLBCL).
Authors: Belada David , Kopeckova Katerina , Bergua Burgues Juan Miguel , Stevens Don A. , Nowakowski Grzegorz S. , Waldron-Lynch Maeve , Hadar Nira , Weirather Johannes , Lässig Charlotte , Blair Derek , Dreyling Martin H. 
Published: June 2022

e19553 Background: The combination of tafa + LEN has accelerated approval in the United States (2020) and conditional approval in Canada and Europe (2021) for R/R DLBCL in ASCT-ineligible adult pts. A tolerable safety profile for R-CHOP + tafa ± LEN in pts with newly diagnosed DLBCL in the Phase Ib First-MIND study (NCT04134936) was previously reported, with numerically superior efficacy for R-CHOP + tafa + LEN (ASH 2021; #3556). We report PK, PD, and immunogenicity of R-CHOP + tafa ± LEN in this first line setting. Methods: Eligible pts ≥18 years with treatment-naïve DLBCL, IPI 2–5, and ECOG PS 0–2 were randomized 1:1 to either six 21-day (D) cycles (C) of R-CHOP (R-CHO, D1; P, D1–5) + tafa (12 mg/kg IV, D1, 8, 15) (Arm A) or R-CHOP + tafa + LEN (25 mg orally, D1–10) (Arm B). Secondary endpoints included tafa serum conc and number and percentage of pts developing anti-tafa Abs. Exploratory endpoints included natural killer (NK) cell, T-cell, and B-cell count in peripheral blood. Results: Data cut-off: 13 March 2021 for safety analysis, incl. ≥1 month follow-up after EoT visit for all pts; 15 September 2021 for efficacy. Tafa serum conc reached steady state by C3 (geometric mean trough conc: Arm A, 186.40–216.55 µg/mL; Arm B, 171.77–201.54 µg/mL) and steadily declined after treatment completion. Anti-tafa Abs were detected in 1/65 (1.5%) pts. This pt showed pre-existing tafa Abs at baseline, which decreased during treatment. Median NK cell count decreased from baseline at C1D8 but was at baseline or higher levels by EoT visit (Arm A) and C1D15 (Arm B; Table). T-cell count decreased from baseline at C1D8 in both arms but was at baseline level or higher by C1D15 (Arm A) and EoT visit (Arm B). Median B-cell count decreased from baseline to 0 cells/μL (Arm A, C1D15; Arm B, C1D8); at 6-month follow-up after EoT visit, B-cell count had recovered to measurable levels in ̃50% of pts. Conclusions: Tafa serum conc reached and maintained a therapeutic dose level in this first-line regimen and declined in line with known tafa half-life (̃16 days) after treatment completion; tafa levels were comparable between the two treatment arms. No pt developed treatment-induced or treatment-boosted anti-tafa Abs. Median NK-cell, T-cell, and B-cell counts were comparable between treatment arms in all cycles. Clinical trial information: NCT04134936. [Table: see text]
Clinical laboratory mutation analysis performed on aggressive B cell non-Hodgkin lymphoma patient biopsies.
Authors: Landsburg Daniel J , Caponetti Gabriel C. , Bagg Adam , Schuster Stephen J. , Nasta Sunita , Gerson James M. , Frank Dale M. , Barta Stefan K. , Svoboda Jakub , Bhattacharyya Siddharth , Qualtieri Julianne N , Lim Megan S. , Chong Elise A. , Roth Jacquelyn , Priore Salvatore F. , Deihimi Safoora , Morrissette Jennifer J. 
Published: June 2022

e19561 Background: Results from comprehensive genomic analysis performed on aggressive B cell non-Hodgkin lymphomas (aBNHL) patient (pt) biopsies (bx) have identified mutations (mut) which may be predictive of pt survival. However, results from mut analysis (MA) performed on aBNHL pt bx in clinical laboratories are not well-described. Methods: Bx diagnostic of non-Burkitt aBNHL obtained from 7/2015-2/2021 with MA performed in the Penn Center for Personalized Diagnostics clinical laboratory using 3 consecutive versions of lymphoma sequencing panels were retrospectively analyzed. Mut tested varied by panel. Mut detected with variant allele frequency (VAF) ≥10% were included. Results: MA was performed on 293 aBNHL pt bx with a successful assay for 270 (7.8% failure rate). Request for MA was made by interpreting hematopathologist 93% and treating clinician 7%. Median turnaround time (TAT) from receipt of bx to result report was 18 (range 8-53) days. Notable pt characteristics included prior/concurrent indolent lymphoma (IL) 31% and prior systemic therapy received for IL and/or aBNHL 38%. Notable bx characteristics included bx type paraffin-embedded tissue 85% and bone marrow 12%, histologic classification diffuse large B cell lymphoma 86% and high grade B cell lymphoma 13%, cell of origin (COO) by Hans algorithm non-germinal center B (non-GCB) 51% and GCB 44%, known double expressor lymphoma 30%, known MYC rearrangement 18%, known double hit lymphoma 9% and any mut detected with VAF ≥10% 82%. Number and percentage of mut occurring in ≥10% of bx (minimum tested bx for mut ≥92) with associated COO are listed in the table. Subset analysis of 147 bx obtained from pts with newly-diagnosed aBNHL (15% with previously-untreated IL) had similar bx characteristics to the entire population were analyzed for the presence of mut reported in poor-prognosis COO-associated classifications: Cluster 5 for non-GCB and Cluster 3 for GCB (PMID: 29713087), double-hit signature (DHITsig) for GCB (PMID: 30523716) and molecular high grade (MHG) for GCB (PMID: 30523719). For 77 non-GCB bx, 19% had Cluster 5 mut. For 59 GCB bx, 56% had at least one of Cluster 3, DHITsig or MHG mut. Conclusions: Clinical laboratory MA performed on nearly 300 aBNHL pt bx was highly successful with a short TAT and demonstrated recurrent gene mut associated with aBNHL development. In the subset of bx from previously-untreated pts, MA identified mut associated with poor-prognosis genetic subtypes of aBNHL.[Table: see text]
Real-world treatment patterns in patients with Sézary syndrome in the United States and the impact of Covid-19.
Authors: Zhao Yang , Tang Jackson , Zhou Huanxue , Takahashi Takeshi , Nomura Takanobu , Dennis Eslie , Akilov Oleg 
Published: June 2022

e19578 Background: Sézary syndrome (SS) is an aggressive type of cutaneous T-cell lymphomas (CTCL). Due to its low prevalence, there are limited data on real-world treatment patterns of currently available SS therapies. Furthermore, recent approvals of new agents for patients with CTCL as well as COVID-19 likely impacted real-world treatment patterns. Objective: To examine real-world treatment patterns and the impact of COVID-19 among SS patients treated in 2018-2020 in the US. Methods: Patients with public or private insurance in the 2018-2020 Symphony Health Solutions database were classified into 3 groups: ≥1 diagnosis of SS (ICD-10-CM code: C84.1x) in 2018, 2019, and 2020, respectively. Patient characteristics and treatment patterns for all therapies recommended by the National Comprehensive Cancer Network guidelines version 2.2021 were examined: systemic therapy (e.g., extracorporeal photopheresis (ECP), parenteral, or oral agents), skin-directed therapy (SDT, e.g., topical, local radiation, total skin electron beam therapy, or phototherapy) and bone marrow transplant. The impact of COVID-19 was assessed via quarterly analysis. National drug codes, current procedural terminology and healthcare common procedure coding system codes were used to identify all treatments. Results: The analyses included 869, 882, and 853 SS patients in 2018, 2019, and 2020, respectively (mean age: 66.3, 66.9 and 67.3 years; male: 54.4%, 54.8%, and 55.6%). Overall, systemic therapy increased from 2018 to 2020 (41.8% to 46.5%), with increased parenteral (20.7% to 28.7%) but decreased ECP (17.0% to 13.5%) usage. SDT increased from 2018 to 2020 (48.9% to 52.9%), with increased topical (42.3% to 48.3%) but decreased phototherapy (6.3% to 4.1%) usage. ECP, mogamulizumab, and bexarotene were the most prescribed systemic therapies in 2019-2020, with mogamulizumab being the only one with increased usage over time. Quarterly analysis showed a decreasing ECP from Q1 to Q4 within each year, with a notable drop in Q2 2020. For parental systemics, there was an increasing trend in 2019 and 2020, but utilization in Q4 2020 was lower than that of Q3 2020. For oral systemic, there was a notable drop in Q2 2020 but an increased trend in Q3-Q4 2020. Conclusions: This claims analysis indicated increased use in systemic and SDT among SS patients in 2018-2020. The quarterly analysis indicated that the drop in ECP and oral systemic usage in Q2 2020 coincided with the onset of the pandemic, but there was a stable use of parenteral systemic during 2020.