Clinical Outcomes From Venetoclax Based Therapy in Patients With Relapsed/Refractory B‐cell Lymphomas

Abstract

Introduction: Thromboembolism (TE) is common and one of major causes of morbidity and mortality in patients with malignancy. The neutrophil to lymphocyte ratio (NLR) and the platelet to lymphocyte ratio (PLR) are biomarkers for systemic inflammation. Principal advantage of NLR and PLR is their modest computability from complete blood count (CBC). Several publications showed predictive strength of high NRL for development of venous thromboembolism (VTE) in cancer patients receiving chemotherapy. However, the prognostic values of the NLR and PLR in patients with lymphoma have not been elucidated. We aimed to investigate the association between NLR, PLR and future risk of TE, in a prospective cohort of lymphoma patients receiving chemotherapy.Methods: A total of 484 patients who were diagnosed with lymphoma (including non-Hodgkin and Hodgkin lymphoma; excluding chronic lymphocytic leukemia/small lymphocytic lymphoma) at the Clinic for Hematology, Clinical Centre of Serbia, were prospectively included in the study. Data for newly diagnosed and relapsed patients who had completed a minimum of one chemotherapy cycle were collected for all venous and arterial TE events from time of diagnosis to 3 months after the last cycle of therapy. NLR and PLR were calculated according to the CBC. TE was diagnosed objectively based on radiographic studies, clinical examination, and laboratory evaluation. Logistic regression analysis and ROC curve were performed to assess the association of NLR and PLR with TE. Results: The mean patients' age was 53 years (range, 18-89 years); 52.3% were males. Most patients were newly diagnosed and had advanced stage disease: Ann Arbor stage III 21.1% and stage IV, 42.5%. A total of 242 patients (50.0%) had high-grade NHL; 137 (28.3%) had low-grade NHL; 84 (17.4%) had HL; 21 (4.3%) had Background: B-cell non-Hodgkin lymphomas (B-NHL) are frequently characterised by deregulation of the B-cell leukaemia/lymphoma-2 (BCL2) family of anti-apoptotic proteins. Venetoclax is a BCL2-specific inhibitor approved for chronic lymphocytic leukemia (CLL), with activity in other B-cell malignancies in small cohorts. Venetoclax has been available for patients (pts) with relapsed/refractory B-NHL via the Abbvie compassionate access scheme or as off label treatment, however data regarding effectiveness in this setting are scarce. Methods: We performed a multicentre, international, retrospective study of the clinical outcomes and safety of pts with B-NHL (excluding CLL) who received venetoclax either as monotherapy or as combination treatment in Australia or Denmark between 7/2016 and 12/2018. Results: The baseline characteristics of the 24 eligible pts are summarised in the table (Figure 1a). Target daily dose varied from 400-1200mg and was reached in 77%. Among all pts, the objective response rate (ORR) was 35%, clinical benefit rate (SD/PR/CR) 65% and CR rate 8%; one patient each with MCL and transformed follicular lymphoma. The Waldenstrom macroglobulinaemia patient ABSTRACT 535 achieved a MR with monotherapy, impr...