PS1093 IN ELDERLY PATIENTS WITH NEWLY DIAGNOSED DLBCL, CHANGE WEIGHT AFTER THE FIRST COURSE R‐CHOP (‐LIKE) CHEMOTHERAPY IS AN ADVERSE PROGNOSTIC FACTOR

Background: The incidence of DLBCL increases with age, with over 40% of patients being 70 years old or older. DLBCL has often treated with R‐CHOP (‐like) regimen of 6–8 course, but many elderly patients are exhausted during the treatment. According to the CTCAE (ver5.0), weight change 10% from baseline was defined as grade 2. However, in elderly DLBCL patients, the change effect on their survival. Aims: We conducted a retrospective cohort study examining the influence of change body weight after the first chemotherapy on their outcome and survival. Methods: Clinical records of 236 patients who had received R‐CHOP (‐like) regimen were retrospectively analyzed. They were newly diagnosed DLBCLby WHO 2008 criteria. They were treated at Japanese Red Cross Kyoto Daiichi Hospital between January 1st, 2008 and October 31st, 2018. Data on clinical characteristics and treatment modalities were obtained by review of medical charts. Body weight was taken as the average over 3 days before chemotherapy started. We grouped as follows; old‐plus(≧ 70 years and weight change more than 10% over from baseline 10% over from baseline), old‐minus(≧ 70 years and not weight change 10% over from baseline), young‐plus(<70 years and weight change 10% over from baseline), young‐minus(<70 years and not weight change 10% over from baseline). Progression‐free survival (PFS) and overall survival (OS) were estimated using the Kaplan‐Meier method. We set the primary endpoint as the 5‐year overall survival (5yOS) which was evaluated by using a log‐rank test. We defined 5yOS as the time from first chemotherapy to any cause of death. Results: We analyzed 236 patients (142 males, 94 females) and 131(55.6%) was 70 years and over. 65 patients were ECOG PS>1. Old‐plus were 18 patients, and old‐minus were 113, young‐plus were 9, young‐minus were 96. The 5‐year OS rate of all was 67.2% (95%Cl: 59.3–73.9%), PFS rate was 64.9% (95%Cl: 57.2–71.5%) in all patients. The average of change weight after the first therapy was 5.05%. In elderly patients changing in body weight more than 10% over from baseline after the first therapy had worse clinical outcomes with shorter 5yOS (63.3% vs. 18.7%, P <0.001 HR 3.469, 95% CI 1.708 to 7.048, see figure 1). However, there is no significant difference in young people (5yOS 77.9% vs. 46.7%, P  = 0.221 HR 2.113, 95% CI 0.62 to 7.202, see figure 2). Summary/Conclusion: Weight change 10% from baseline after the first therapy was associated with poor outcomes in elderly people with Newly Diagnosed DLBCL (see figure 3).This could suggests that adjusting drug dosage in the second therapy in those patients will improve their survival.