Page 183 - Haematologica Vol. 110 - January 2025

LETTER TO THE EDITOR
Table 1. Main characteristics of the overall cohort of patients included in the study and an evaluation of these variables using a
propensity score analysis based on inverse probability of treatment weighting.
Variables
Overall N=215
Benda N=20
No benda N=195
SMD
Overall
Benda
No benda
SMD
Age, median (IQR)
59 (52-68)
62 (58-73)
59 (52-67)
0.0001
60 (53-63)
60 (53-63)
59 (52-68)
0.0994
Sex, N (%) FM
104 (48) 111 (52)
9 (45) 11 (55)
95 (49) 100 (51)
-0.0750 0.0750
(47) (53)
(46) (54)
(48) (52)
-0.0194 0.0194
Diagnosis, N (%) MCL
FL
37 (17) 178 (83)
6 (30) 14 (70)
31 (16) 164 (84)
0.3400 -0.3400
(17) (83)
(18) (82)
(17) (83)
0.0096 -0.0096
Stage, N (%) I/II
II/IV
25 (12) 190 (88)
2 (10) 18 (90)
23 (12) 172 (88)
-0.0580 0.0580
(12) (88)
(13) (87)
(12) (88)
-0.0539 0.0539
B symptoms, N (%) No
Yes
179 (83) 36 (17)
15 (75) 5 (25)
164 (84) 31 (16)
-0.2270 0.2270
(81) (19)
(77) (23)
(84) (16)
-0.0702 0.0702
ASCT, N (%) No
Yes
192 (89) 23 (11)
19 (95) 1 (5)
173 (89) 22 (11)
0.2310 -0.2310
(90) (10)
(90) (10)
(89) (11)
0.011 -0.011
Vaccination, N (%) No
Yes
19 (9) 195 (91)
3 (15) 17 (85)
16 (8) 178 (92)
0.2120 -0.2120
(11) (89)
(13) (87)
(8) (92)
0.0513 -0.0513
FLIPI/MIPI, N (%) High
Intermediate Low
49 (24) 123 (59) 36 (17)
9 (47) 7 (37) 3 (16)
40 (21) 116 (61) 33 (17)
0.2620 -0.2453 -0.0167
(24) (56) (20)
(25) (52) (23)
(24) (59) (17)
-0.0177 0.0156 -0.0696
Best response, N (%) CR
PR
167 (78) 48 (22)
16 (80) 4 (20)
151 (77) 44 (23)
0.0630 -0.0630
(82) (18)
(87) (13)
(78) (22)
0.0949 -0.0949
ASCT: autologous stem cell transplantation; benda: bendamustine; CR: complete response; F: female; FLIPI: Follicular Lymphoma Interna- tional Prognostic Index; FL: follicular lymphoma; IQR: interquartile range; M: male; MCL: mantle cell lymphoma; MIPI: Mantle Cell Lymphoma International Prognostic Index; N: number; PR: partial response; SMD: standardized mean differences.
tologous stem cell transplantation (ASCT) was performed in 23 patients (11%): 3 patients with FL and 20 patients with MCL. Following the IPTW analysis, baseline variables, including those associated with an impact on SARS-CoV-2 infection outcomes, such as age, vaccination status, and prognostic score (Follicular Lymphoma International Prog- nostic Index [FLIPI] or Mantle Cell Lymphoma International Prognostic Index [MIPI]) were similar in both groups (SMD <0.1). Response after maintenance was similar between cohorts, with an overall response rate of 100% versus 84% for bendamustine and cyclophosphamide, respectively (P=0.654). Temporary interruptions or dose delays during maintenance due to SARS-CoV-2 infection were reported in 95 (44%) cases and definitive suspensions of treatment in 47 (22%) patients. No significant differences in the rate of maintenance delays (55% bendamustine vs. 43% cy- clophosphamide, P=0.24) or definitive interruptions (30%
bendamustine vs. 21% cyclophosphamide, P=0.204) were observed between groups. SARS-CoV-2 infection was re- ported in 77 (36%) patients in the full patient population, with a higher rate of infection in the bendamustine group compared to the cyclophosphamide group (60% vs. 33%, P=0.026). Thirty-five (16%) patients were hospitalized due to severe COVID-19 disease, and 9 (4%) patients required ICU admission, with higher rates of both endpoints in the bendamustine group, compared to the cyclophosphamide group: 53% versus 15% hospitalization episodes, respectively (P<0.001) and 26% versus 2% of ICU admission (P<0.001) (Figure 1A). These results were also maintained in the IPTW analysis: 50% versus 15% hospitalization episodes (P=0.003) and 26% versus 2% of ICU admission (P<0.001) (Figure 1B). The severity of SARS-CoV-2 infection was evaluated across different years during the study period, and a sensitivity analysis on the FL cohort was performed
Haematologica | 110 January 2025
175