Brazilian Reality of Diffuse Large B-Cell Lymphoma (BRA - DLBCL): A Multicenter Retrospective Study

Abstract

Background: Despite the improvement in management of Diffuse large B-cell lymphoma (DLBCL) in recent years, the health outcomes of DLBCL patients in low and low-middle income countries is suboptimal. Moreover, clinical presentation, management, treatment, and response rate in Brazil remains not well understood. Considering Brazilian heterogeneous reality and access to different therapies, evidence generated form this study has the potential to help understand the reality of Brazilian patients, as well as support new regional research. Type of study, objectives, and method: This is a Brazilian multicenter retrospective observational study with the purpose of collecting real-world data (RWD) (NCT05958134) in patients with DLBCL. The primary objective of the study is to describe the epidemiological profile of diffuse large B-cell lymphoma and survival outcomes of patients registered and treated over the 6 years, from 2017 to 2022, in oncology care centers located in the southeast and northeast regions of Brazil. Data regarding molecular subgroups, clinical management and response to treatment were collected. Results: The study has already completed the recruitment and inclusion of participants and is currently in the data monitoring and statistical analysis stage. 621 patients were screened and 598 of these were included in the study. The partial results from a sample of 260 participants with monitored data shows 120 (46.2%) female participants and 140 (53.8%) male participants, with a minimum age of 21 years and a maximum age of 99 (Mean (SD): 63.04 (15.13) years). The Region of the country in which the included participants reside are Midwest 2 (0.8%), Northeast 28 (10.8%), North 1 (0.4%), Southeast 227 (87.3%) and South 2 (0.8%). Regarding the declared race: Asian 9 (3.5%), White 114 (43.8%), Indigenous 1 (0.4%), Brown 91 (35.0%), and Black 16 (6.2%). Treatment was carried on Private Healthcare System in 81 patients (31.2%), Public Health System in 174 patients (66.9%), and mixed (Private Healthcare System and Public Health System) in 5 patients (1.9%). Considering the presence of comorbidities, 178 (68.5%) had at least one comorbidity, and 82 (31.5%) had no comorbidity reported in their medical records. Regarding biological features, 130 (50.0%) were diagnosed with Germinal Center DLBCL (GC-DLBCL), 113 (43.5%) were non-GC DLBCL, 15 (5,8%) were classified as high-grade B-Cell lymphoma and 0.8% were classified as other subtypes of DLBCL. When observing the included participants in relation to their diagnoses, the majority underwent treatment and follow-up in the Brazilian public health system. It is also possible to observe a trend of migration from their regions of origin to receive care in health centers in the southeast region. The results regarding the treatment profile adopted in the subgroups by diagnosis, as well as survival outcomes will be fully presented at the meeting. Conclusions: BRA-DLBCL is a multicenter effort to generate structured and reliable real-world evidence of DLBCL diagnosis, treatment and prognosis in Brazil. Analysis of data from this study could bring great insights regarding treatment patterns and help understand patients' needs in low and low-middle income countries. To our knowledge, BRA-DLBCL included the biggest number of newly diagnosed DLBCL patients in Brazil. This study is supported by AstraZeneca.