ABCL-298 Diffuse Large B-Cell Lymphoma During the Covid-19 Pandemic in Two Tertiary Centers: The Israeli/Italian Study

Introduction: The COVID-19 pandemic posed a major challenge in cancer care worldwide, which might have an impact on the management of hematologic malignancies. Aims: To compare the characteristics, management, and outcomes of diffuse large B-cell lymphoma (DLBCL) patients diagnosed during the first year of the COVID-19 pandemic compared to the previous year. Methods: This retrospective study compared DLBCL patients diagnosed from 1/3/2020 to 28/2/2021 and those diagnosed between 1/3/2019 and 28/2/2020 in two tertiary centers in Italy and Israel. Results: A total of 182 patients were diagnosed with DLBCL during the study period in both centers. More patients were diagnosed during the pandemic in both centers compared to the year before (60 vs. 29 and 54 vs. 39 in Italy and in Israel, respectively). Only in the Italian cohort was there a trend towards older age at diagnosis during the pandemic (68 vs. 61 years; P=0.13). The interval between the initiation of symptoms and diagnosis was longer during the pandemic for both cohorts. Five and four patients were diagnosed with COVID-19 during treatment in Italy and Israel, respectively. For both cohorts, there was no difference in dose density or intensity before or during the pandemic. Although in the Italian cohort there was a trend towards lower estimated 1-year PFS (73.7% vs. 89.7%; P=0.06) during the pandemic compared to the year before, there was no such difference in the Israeli cohort. In a univariate analysis for PFS in the Italian cohort, diagnosis during the pandemic was associated with 2.6-fold increased risk for progression (95% CI 0.9–7.2; P=0.07). In multivariate analysis, age was the only independent prognostic factor (HR 1.08, 95% CI 1.03–1.14; P<0.001). Conclusions: In both cohorts, patients' characteristics were comparable between the periods. Yet, more patients were diagnosed with DLBCL during the pandemic, and the interval between symptoms and diagnosis was longer compared to the year before. Still, there was no change in treatment in terms of dose density and intensity. The trend towards a shorter PFS during the outbreak in the Italian cohort can be explained by the older age of the patients treated during this period.