Hemophagocytic Lymphohistiocytosis as the Presenting Symptom of Aggressive Lymphoma ‐ A Case Series and Review of the Literature: NHL‐033
Abstract
Stephen Ansell, Grzegorz Nowakowski, James Cerhan Mayo Clinic, Rochester, Minnesota, United States Context: ThemTOR inhibitor everolimus has encouraging activity in DLBCL. Metformin was shown to have anti-lymphoma activity in vitro via mTOR inhibition, but it’s unclear whether it has clinical activity. Objective: To analyze whether metformin use in DLBCL patients was associated with clinical outcome. Design: Retrospective cohort study. Patients: 869 patients with newly diagnosed DLBCL from 3/2002 to 6/2015 were enrolled in the Molecular Epidemiology Resource of the University of Iowa/Mayo Clinic lymphoma SPORE, treated with standard immunochemotherapy, and followed prospectively. Patients who were on metformin at the time of diagnosis or started metformin within 6 months after diagnosis were assigned to the metformin group. Main Outcomes Measures: Event-free survival (EFS) was defined as time from diagnosis to progression or relapse, unplanned re-treatment, or death from any cause. Overall survival (OS) was defined as time from diagnosis to death from any cause. Time-to-event data were analyzed using Kaplan-Meier method and Cox regression model. Results: 48 (5.5%) patients were in the metformin group. Metformin dose ranged from 500mg daily to 1000mg twice daily. The median duration of use was 37.6 months. Patients in the metformin group were older (median 69 vs 64, P1⁄40.017) and had more frequently elevated LDH (P1⁄40.049). There were no other differences in baseline…
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