Baseline Characteristics of 3046 Non-Hodgkin's Lymphoma Patients Diagnosed between July 2015 and May 2018: A Report from China Lymphoma Patient Registry (CLAP)

Introduction

Lymphoma is the most common hematologic tumor. In 2015 about 88000 new cases was estimated diagnosed in China (Chen et.al, CA Cancer J Clin 2016). China Lymphoma Patient Registry (CLAP) (NCT03313271) is an observational bi-directional cohort study launched in five hospitals in early 2017, aiming to better understand the epidemiology, treatment and prognosis of lymphoma in the country. By the end of March 2018, a total of 3458 lymphoma patients, including 412 Hodgkin's Lymphoma (HL) cases and 3046 Non-Hodgkin's Lymphoma (NHL) cases, had been prospectively and retrospectively recruited. Here we report the demographic and disease baseline characteristics of 3046 NHL patients diagnosed between July 2015 and March 2018.

Method

This is an observational bi-directional cohort study based on medical records of hospitalized lymphoma patients in five CLAP hospitals. In order to be eligible for this particular analysis, patients need to be 1) newly diagnosed as NHL between July 2015 and March 2018 in five participating hospitals; 2) age >=18 yrs old at time of disease diagnosis; 3) given informed consent if prospective follow-up is needed. This study has been approved by Institutional Review Board (IRB) from all study sites. Medical records of newly diagnosed NHL patients were systematically reviewed and study data were manually entered or directly transferred into a predesigned electronic database with the support of Medbanks Network Technology Co., Ltd. Descriptive analysis was used to understand the distribution of patient demographic information (age, gender, medical history, etc.), disease baseline characteristics (symptoms, score, stage, etc.) and initial treatment options (if Rituximab) for NHL population as a whole as well as by subtype stratification.

Result

A total of 3046 newly diagnosed NHL patients were identified between July 2015 and March 2018, and diffuse large B cell lymphoma (DLBCL) was the most common subtype (48.2%)(Figure1). Males accounted for 55.4% of the total study population and were very dominant in mantle cell lymphoma (MCL) (79.8%), but females were more common in Follicular lymphoma (FL) (53.7%) and Marginal zone lymphoma (MZL) (52.8%). The median age of all study subjects was 58yrs old (range 18-95) and patients with FL (51yrs) and T-cell lymphoma (TCL) (52yrs) was relative younger compared with other subtypes. The general health status of most NHL patients was relative good at first diagnosis, the percentage (excluding missing) of patient with recorded B symptoms, ECOG-PS score >=2 and IPI score3-5 were 39.0%, 4.8% and 26.8%, respectively. Among B-cell lymphoma (BCL), Rituximab was most frequently used in patients with FL (63.4%) followed by DLBCL (61.1%), and MCL (58.5%) (table1). Hypertension was the most common comorbidity and over 16% NHL patients had reported concomitant hypertension followed by diabetes (7.9%), hepatitis B (4.4%), coronary heart disease (3.3%) and tuberculosis (1.4%) (Figure2). Previous personal history of cancer and family history of cancer were reported by 2.8% and 12.5% of study subjects, respectively (Figure3).

Conclusion

Among all CLAP participants, NHL accounts for nearly 90% of all lymphoma patients, which is consistent with the report from national cancer registry (He, Chen, Chinese Cancer Registry Annual Report 2016) and demonstrates a well representativeness of NHL patients in China. NHL is a composite of many types of lymphoma and each subtype had unique histological, clinical and prognostic characteristics. Although previous studies had reported the pathology distribution of NHL in China (Sun et.al, Am J Clin Pathol 2012; Cao et.al, Ann Diagn Pathol. 2018), very few have more detailed information on disease characteristics and treatment. As a big observational study focus on lymphoma, this registry provides a unique opportunity and platform to understand the whole picture of NHL diagnosis, treatment and prognosis in real world.

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