Presenting International Prognostic Scoring System affects time to treatment: A retrospective single centre review
Standing
Undergraduate
Type of Proposal
Poster Presentation
Challenges Theme
Open Challenge
Your Location
Windsor
Faculty
Schulich School of Medicine Windsor
Faculty Sponsor
Dr. Indryas Woldie, Dr. Caroline Hamm
Proposal
Background
Diffuse large B cell lymphoma (DLBCL) is an aggressive form of non-Hodgkin’s lymphoma, which requires prompt initiation of chemotherapy to cure, as delays can result in worse outcomes. A recent study in Japan found that patients with an International Prognostic Index (IPI) score ≥3 had a worse prognosis if their diagnosis was delayed, whereas with an IPI score <3, there was no effect.
Research Question
How long do Windsor DLBCL patients wait to receive chemotherapy after diagnosis, and how does this affect relapse status?
Methods
A retrospective chart review was conducted, looking at all patients diagnosed with DLBCL who underwent treatment at the Windsor Regional Cancer Center from 2007 to 2018 (N=317).
Results
Surprisingly, a longer time to initial treatment resulted in a decreased risk of relapse (p=0.038); however, these patients tended to have a lower stage (p=0.002), no family history of cancer (p<0.001), and lower IPI scores (p=0.004). When broken down by IPI score, the mean times to treatment after diagnosis were: IPI 0=40 days; IPI 1=35 days; IPI 2=38 days; IPI 3=29 days; IPI 4=22 days; IPI 5=29 days.
Conclusion
These results show that while DLBCL patients with worse prognostic measures are prioritized to receive treatment quicker, there is a large discrepancy in time to treatment, with a difference of over a week between the lowest and highest IPI scores. Further research should focus on identifying delays in the process, and if it can be streamlined to improve wait times for all patients, regardless of IPI score.
Presenting International Prognostic Scoring System affects time to treatment: A retrospective single centre review
Background
Diffuse large B cell lymphoma (DLBCL) is an aggressive form of non-Hodgkin’s lymphoma, which requires prompt initiation of chemotherapy to cure, as delays can result in worse outcomes. A recent study in Japan found that patients with an International Prognostic Index (IPI) score ≥3 had a worse prognosis if their diagnosis was delayed, whereas with an IPI score <3, there was no effect.
Research Question
How long do Windsor DLBCL patients wait to receive chemotherapy after diagnosis, and how does this affect relapse status?
Methods
A retrospective chart review was conducted, looking at all patients diagnosed with DLBCL who underwent treatment at the Windsor Regional Cancer Center from 2007 to 2018 (N=317).
Results
Surprisingly, a longer time to initial treatment resulted in a decreased risk of relapse (p=0.038); however, these patients tended to have a lower stage (p=0.002), no family history of cancer (p<0.001), and lower IPI scores (p=0.004). When broken down by IPI score, the mean times to treatment after diagnosis were: IPI 0=40 days; IPI 1=35 days; IPI 2=38 days; IPI 3=29 days; IPI 4=22 days; IPI 5=29 days.
Conclusion
These results show that while DLBCL patients with worse prognostic measures are prioritized to receive treatment quicker, there is a large discrepancy in time to treatment, with a difference of over a week between the lowest and highest IPI scores. Further research should focus on identifying delays in the process, and if it can be streamlined to improve wait times for all patients, regardless of IPI score.