Title

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

Abstract/Description of Original Work

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.

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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.