American Society of Hematology (ASH) 2022 Involvement: The Lymphoma Epidemiological Outcomes (LEO) Cohort

At Weill Cornell Medicine (WCM) and NewYork-Presbyterian, we are proud to partner with the Lymphoma Epidemiological Outcomes (LEO) Cohort for a variety of research projects aimed to change the way we understand and manage lymphoma, a broad category which encompasses nearly 80 different distinct disease types. The LEO Cohort is the largest, most diverse study of lymphoma patients in the world to-date, comprised of participants from eight large U.S. academic centers.

At the 2022 American Society for Hematology (ASH) annual meeting, several studies involving the WCM Lymphoma Program, which included results and analyses from the LEO Cohort, were selected to be presented.

Weill Cornell Lymphoma Program Chief, Dr. Peter Martin, shares his gratitude for the patients who have participated in this research, as they’ve played an integral role in helping move the field forward and expanding our knowledge of this disease.

I would like to thank our amazing patients who are participating in the Lymphoma Epidemiology of Outcomes (LEO) cohort study, the largest, most diverse cohort study of lymphoma patients anywhere. Your dedication, along with fellow participants at eight institutions around the country, has resulted in multiple abstracts being presented at the 2022 Annual Meeting of the American Society of Hematology. These include studies in follicular lymphoma, diffuse large B-cell lymphoma, and marginal zone lymphoma. With dozens of additional studies already reported or underway, the LEO cohort is poised to change the way we understand and manage lymphoma over the decade to come.

Peter Martin, MD

Learn more about research presented at the ASH 2022 Conference from the LEO Cohort data:

Abstract #1591: Patterns of Care and Clinical Outcomes in Peripheral T-Cell Lymphomas: The Lymphoma Epidemiology of Outcomes (LEO) and Molecular Epidemiology Resource (LEO-MER) Prospective Cohort Study

Dr. Jia Ruan presented on this multi-center prospective cohort study analyzing the patterns of care and clinical outcomes of patients diagnosed with peripheral T-cell lymphoma (PTCL), a rare and heterogenous group of non-Hodgkin lymphoma. This research included 718 PTCL patients enrolled in the National Cancer Institute (NCI) supported Molecular Epidemiology Resource (MER) and the Lymphoma Epidemiology of Outcomes (LEO) cohort from 2002-2020. The study showed increased demographic diversity with time, and an increased use of novel agents such as brentuximab vedotin in the initial treatment setting. CHOP-based induction chemotherapy was the most common treatment in the LEO-MER cohort, despite being suboptimal particularly for patients with PTCL subtypes other than the anaplastic large cell lymphoma, including PTCL not otherwise specified (NOS) subtype and angioimmunoblastic T-cell lymphoma. These results warrant further research to develop therapies with targeted agents tailored to these different subtypes of PTCL.

Abstract #4207: Predictive Value of Staging PET/CT to Detect Bone Marrow Involvement in Marginal Zone Lymphoma (MZL): An Analysis from LEO MZL Working Group

This study led used prospectively collected data from the LEO Cohort to assess the predictive value of using PET/CT scans to detect bone marrow involvement and survival implications in marginal zone lymphoma (MZL) patients. The team looked at 311 MZL patients enrolled in the LEO Cohort who had data on bone marrow involvement and both biopsy and PET/CT results. The initial results, with short-term follow-up, showed low sensitivity to assessing bone marrow involvement using PET/CT data across all MZL subtypes. Additionally, splenic MZL demonstrated low negative predictive values for this assessment. These results highlight the limitations for MZL patients in current staging criteria.

Abstract #2957: Outcomes and Prognostic Factors of Transformed Follicular Lymphoma: An Analysis from the LEO Consortium

In this abstract, the team evaluated histological transformation (HT) in follicular lymphoma (FL) patients by examining prognostic factors for and outcomes following HT in patients enrolled in the LEO Cohort. HT from FL to an aggressive cancer is rare but when it does occur, is associated with unfavorable outcomes. This observational cohort study looked at patients diagnosed between 2002-2019 with FL who progressed through HT to an aggressive lymphoma, totaling 306 patients. The results confirmed previous reports of negative prognostic indicators being early HT, prior immunochemotherapy treatment, and anthracycline exposure, while also extending this observation to any systemic treatment. Patients who had HT and were older than 70 years old had worse overall survival rates. This study found that HT continues to be an unmet need concerning high lymphoma-related mortality and further research is needed to create a more refined prognostic model, to better understand these factors and the influence of patterns of care on outcomes.

Abstract #850: Evaluating the Impact of Lab-Based Eligibility Criteria By Race/Ethnicity in Frontline Clinical Trials for Diffuse Large B-Cell Lymphoma (DLBCL): A LEO Cohort Analysis

Data has shown that patients treated with immunochemotherapy who are ineligible for frontline clinical trials based on lab results have worse clinical outcomes and increased death rates from lymphoma progression. In this study, the team wanted to address this question of limiting eligibility for frontline clinical trials based on lab results. They did this by investigating the LEO Cohort where they analyzed 2330 newly diagnosed diffuse large B-cell lymphoma (DLBCL) patients between 2015-2020 who had 3 or more lab-based values for comparison. These patients were prospectively followed, and all received the same treatment course. Their results found that patients who were deemed ineligible for frontline clinical trials had significantly inferior overall survival, consistent with the previously determined association between ineligibility and poor outcomes. This larger, more diverse study confirmed previous assumptions, and found that specifically for Hispanic/non-white patients, there are some criteria that disproportionately limit eligibility. Further research is needed to evaluate the impact of each lab-based criteria on eligibility in different racial/ethnic populations and to determine how to tailor eligibility criteria to be more inclusive of the most excluded populations.

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