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Diffuse large B cell lymphoma characteristics and outcomes during the COVID-19 pandemic in two tertiary centers - an Israeli/ Italian study

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Abstract

The COVID-19 pandemic posed a major challenge in cancer care worldwide which might have an impact on the management of diffuse large B-cell lymphoma (DLBCL). We conducted a retrospective study comparing characteristics, management, and outcomes of DLBCL patients diagnosed during the first year of the COVID-19 pandemic (1/3/2020–28/2/2021) to those diagnosed in the previous year (1/3/2019–28/2/2020) in two tertiary centers in Italy and Israel. 182 patients were diagnosed with DLBCL during the study period. More patients were diagnosed during the pandemic compared to the year before: 60 vs. 29 and 54 vs. 39 in Italy and in Israel, respectively. Trends towards older age and higher transformation rates were shown during the pandemic. The interval between the initiation of symptoms and diagnosis was longer during the pandemic. Five and four patients were diagnosed with COVID-19 during treatment in Italy and in Israel, respectively. there was no difference in dose density and intensity of treatment, before and during the pandemic. The median follow-up during and before the pandemic was 15.2 and 25.5 months, respectively. Progression-free survival (PFS) was slightly shorter during the pandemic compared to the year before (64.9% vs. 70.6%; p = 0.0499). In multivariate analysis, older age and transformed disease were independently related to PFS, while diagnosis of DLBCL during the pandemic was not. Despite the challenges caused by COVID-19 pandemic, the management of DLBCL patients remained unchanged including dose density and intensity. Nevertheless, a shorter PFS during the outbreak might be attributed to differences in patients’ characteristics.

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Data availability

The data supporting this study’s findings are available from the.

corresponding author, TB, upon reasonable request.

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Funding

No funding was received for conduction this study.

Author information

Authors and Affiliations

  1. Institute of Hematology, Davidoff Cancer Center, Rabin Medical Center, Beilinson Hospital, Petah-Tikva, Israel

    Odil Giladi, Shai Shimony, Oren Pasvolsky, Tamar Berger, Gilad Itchaki, Pia Raanani & Ronit Gurion

  2. Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Odil Giladi, Shai Shimony, Oren Pasvolsky, Tamar Berger, Gilad Itchaki, Pia Raanani & Ronit Gurion

  3. IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia “Seràgnoli”, Bologna, Italy

    Gianmarco Bagnato, Marianna Gentilini, Ginerva Lolli, Vittorio Stefoni, Alessandro Broccoli & Pier Luigi Zinzani

  4. Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy

    Gianmarco Bagnato, Marianna Gentilini, Ginerva Lolli, Vittorio Stefoni, Alessandro Broccoli, Lisa Argnani & Pier Luigi Zinzani

  5. Department of Medical Oncology, Dana Farber Cancer Institute, Boston, MA, USA

    Shai Shimony

  6. Department of Stem Cell Transplantation and Cellular Therapy, University of Texas M.D. Anderson Cancer Center, Houston, TX, USA

    Oren Pasvolsky

  7. Laboratory of Genome Maintenance, The Rockefeller University, New York, NY, USA

    Tamar Berger

  8. Hematology Institute, Meir Medical Center, Kfar Saba, Israel

    Gilad Itchaki

Authors
  1. Odil Giladi
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  2. Gianmarco Bagnato
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Contributions

OG, OP and RG conceived the presented idea for the study and designed the research study. OG, GB, MG, TB, GI, GL, VS, AB LA and RG identified through databases DLBCL patients as potential candidates for the study and collected the data. OG, SS, LA and RG analysed the data. OG, AGG and RG drafted the manuscript. SS, OP, LA, PLZ contributed to the interpretation of results and along with SS, OP, PR, LA and PLZ critically revised the paper. All authors approved the submitted and final version of the manuscript.

Corresponding author

Correspondence to Odil Giladi.

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Conflict of interest

Tamar Berger –Advisory committees: Janssen, Neopharm; (honoraria, advisory committee); honoraria: Janssen. Pia Raanan - Consultancy: Pfizer, Novartis, Bristol Myers Squibb; Advisory committee: Pfizer; Speaker bureau: Janssen; research support: Pfizer, Novartis. Pier Luigi Zinzani - Consultancy: BeiGene, Bristol-Myers Squibb, Takeda, EUSA Pharma, ADC Therapeutics, Merck Sharp & Dohme, Celgene, Celltrion, Kyowa Kirin, Roche, Verastem, Sandoz, Novartis, Incyte, TG Therapeutics Inc, Servier, Janssen-Cilag, Gilead, ImmuneDesign, Sanofi; Membership on an entity’s Board of Directors or advisory committees: BeiGene, Bristol-Myers Squibb, Takeda, EUSA Pharma, ADC Therapeutics, Merck Sharp & Dohme, Celgene, Celltrion, Kyowa Kirin, Roche, Verastem, Sandoz, Novartis, Incyte, TG Therapeutics Inc, Servier, Janssen-Cilag, Gilead, ImmuneDesign, Portola, Sanofi, AbbVie; Speakers Bureau: BeiGene, Bristol-Myers Squibb, Takeda, EUSA Pharma, Merck Sharp & Dohme, Celgene, Celltrion, Kyowa Kirin, Roche, Verastem, Sandoz, Novartis, Incyte, TG Therapeutics Inc, Servier, Janssen-Cilag, Gilead, ImmuneDesign, Portola, AbbVie; Honoraria: Bristol Myers Squibb, Takeda, EUSA Pharma, ADC Therapeutics, Merck Sharp & Dohme, Kyowa Kirin, Roche, Verastem, Incyte, TG Therapeutics Inc, Servier, Janssen-Cilag, AbbVie; Research funding: Portola. Ronit Gurion – Advisory committees: Roche, Gilead, Medison Ltd, Novartis, Abbvie; Honoraria: Roche, Gilead, Medison Ltd, Novartis, Abbvie and Takeda. All other authors have no relevant financial or non-financial interest to disclose.

Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. Approval was obtained from Rabin Medical Center (RMC) and Seragnoli Institutional Review Board (IRB) ethics committee.

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Informed consent was waived due to the retrospective design of the study.

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Giladi, O., Bagnato, G., Gentilini, M. et al. Diffuse large B cell lymphoma characteristics and outcomes during the COVID-19 pandemic in two tertiary centers - an Israeli/ Italian study. Ann Hematol 103, 803–811 (2024). https://doi.org/10.1007/s00277-023-05543-5

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