Time to Next Treatment Within 24 Months (TTNT24) as a Predictor of Survival in Lymphoplasmacytic Lymphoma/Waldenström Macroglobulinemia: A Population-Based Observational Study
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Published on: February 25, 2020
Lars Munksgaard1,2, Lars Moeller Pedersen1,2, Amalie Sofie Eilsoe Munksgaard1,2
1Department of Hematology, Zealand University Hospital, Roskilde, Denmark.
Introduction:
Prognostic models in Waldenström's macroglobulinemia (WM) are typically static, baseline tools applied before treatment initiation and do not account for dynamic post-treatment factors. We evaluated time to next treatment within 24 months (TTNT24), as a prognostic marker in symptomatic patients, and time to lymphoma treatment within 24 months (TTLT24) in initially observed asymptomatic patients.
Methods:
In this observational cohort study, patients diagnosed with lymphoplasmacytic lymphoma/Waldenström macroglobulinemia (LPL/WM) in Region Zealand from 2000 to 2023 were identified using Danish national registries and health records. TTNT24 was defined as initiation of second-line treatment within 24 months of first-line therapy. TTLT24 was defined as lymphoma-directed treatment initiated within 24 months of diagnosis in initially asymptomatic patients.
Results:
Among 526 LPL/WM patients, 218 symptomatic patients were evaluated for TTNT24 with 33 (15%) patients receiving second-line treatment within 24 months. TTNT24-positive patients demonstrated inferior overall and lymphoma-related survival compared to TTNT24-negative patients. TTNT24 remained significant in multivariate analysis. Among 310 asymptomatic patients, TTLT24 was significantly associated only with lymphoma-related survival.
Conclusion:
TTNT24 and TTLT24 may serve as dynamic prognostic markers in real-world LPL/WM populations. Their relevance in the era of targeted therapies warrants further investigation.
