Temporal trends in treatment and survival of older adult diffuse large B-Cell lymphoma patients in the SEER-Medicare linked database

Abstract

To describe temporal trends in treatment among older adult (≥66 years) patients diagnosed with diffuse large B-cell lymphoma (DLBCL), we analyzed 18,058 DLBCL patients from the Surveillance, Epidemiology, and End Results linked Medicare (SEER-Medicare) database diagnosed between 2001 and 2013. Among 65% of patients receiving treatment after diagnosis, R-CHOP (Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, Prednisone) was the most common frontline therapy, increasing with more recent treatment year: 51% (2001–2003) vs. 69% (2010–2014). Autologous and allogeneic hematopoietic stem cell transplantation (HSCT) was uncommon in these Medicare patients. As the addition of rituximab increased over time, we also observed an improved survival rate over time. It is possible there is an association, but we cannot make this inference as effectiveness was not measured in this study. Overall survival estimates indicated that survival probabilities steadily improved in more recent years; however, 5-year survival was <40%, indicating the need for improved treatment options for older adult DLBCL patients.

Keywords:

• Diffuse large B-cell lymphoma
• SEER
• Medicare
• claims
• treatment patterns
• survival

Acknowledgments

This study used the linked SEER-Medicare database. The interpretation and reporting of these data are the sole responsibility of the authors. The authors acknowledge the efforts of the National Cancer Institute; the Office of Research, Development and Information, CMS; Information Management Services (IMS), Inc.; and the Surveillance, Epidemiology, and End Results (SEER) Program tumor registries in the creation of the SEER-Medicare database. The authors acknowledge Elizabeth Leight of Leight Medical Communications, LLC (St. Charles, MO), whose work was supported by Amgen Inc., for providing medical writing support.

Author contributions

All authors participated in data interpretation and drafting of the manuscript, and read, revised and approved the final manuscript.

Potential conflict of interest

Disclosure forms provided by the authors are available with the full text of this article online at http:\\<10.1080/10428194.2019.1623886>

Additional information

Funding

This study was funded by Amgen Inc.