Maurer MJ, et al. - In a clinic-based observational cohort of patients with diffuse large B-cell lymphoma (DLBCL) from the US, researchers assessed the diagnosis-to-treatment interval (DTI) and its impact on clinical factors and outcome. A strong association of DTI with prognostic clinical factors as well as outcome in newly diagnosed DLBCL was demonstrated. All clinical trials of newly diagnosed DLBCL should report DTI, and future trials should avoid selection bias due to delay in treatment.

Methods

• Prospective enrollment of patients in the University of Iowa and Mayo Clinic Specialized Programs of Research Excellence Molecular Epidemiology Resource (MER; N = 986) or the Lymphoma Study Association (LYSA) LNH-2003 clinical trials program (N = 1,444) was carried out.
• At initial diagnosis, anthracycline-based immunochemotherapy was administered to all patients.
• Event-free survival at 24 months from diagnosis (EFS24) was how the outcome was evaluated.

Results

• In the MER and in LYSA, median (range) DTI was 15 days (0 to 155 days) and 23 days (0 to 215 days), respectively.
• Adverse clinical factors were strongly linked to shorter DTI, including elevated lactate dehydrogenase levels, poor performance status, B symptoms, and higher International Prognostic Index in both cohorts (all P < .001).
• Longer DTI was linked to improved EFS24 in both the MER (per-week odds ratio, 0.80; 95% CI, 0.74 to .0.87) and LYSA (per-week odds ratio, 0.90; 95% CI, 0.86 to 0.94).
• After adjustment for International Prognostic Index, the association with EFS24 continued to be significant.