P044 | QUALITY OF LIFE AND TOXICITY IN R/R DLBCL PATIENTS TREATED WITH POLA-BR: A MONOCENTRIC REAL LIFE EXPERIENCE.

Background: QoL and Toxicity in R/R DLBCL patients treated with Pola-BR: a monocentric Real Life Experience. Aim of the work: To evaluate Pola-BR toxicity and to explore the impact on the health-related quality of life (QoL). Patients and Methods: Single center analysis of 12 consecutive R/R DLBCL pts treated with Pola-BR at Hematology Division, University Hospital Catania. In this cohort study, hematological and extrahematological toxicity was collected from medical reports and assessed according to CTCAE v4.0. QoL was explored by a symptoms scale and the EORTC QLQ-C30 questionnaire. Results: Data were collected for 12 R/R DLBCL pts treated with Pola-BR regimen (Table). Median age was 69 yrs (range 58-87), 33% male.10/12 pts presented with stage III/IV and high IPI score. 66%(8/12) had extranodal involvement (GI-tract, lung, breast, bone). 7 pts had a PS-ECOG ≥2. B symptoms in 25% of pts. 9 pts (75%) received Pola-BR as II line, 3/12 as III line of therapy. In II line group: 6/9 pts completed all 6 cycles, although 4/6 patients (66%) had at least one dose delay administration due to AEs (diarrhea and asthenia). 3/9 pts permanently discontinued Pola-BR due to major AEs (1 malignancy,1 IVU,1 PD). In third line: 2 pts completed all 6 cycles and 1 patient discontinued (CoV-19 pneumonia). All patients presented neutropenia. 8/12 pts presented major extrahematologic toxicity (pneumonia, diarrhea, asthenia). The toxicities observed in our study were primarily attributable to the alkylating agent Bendamustine. In contrast, AE associated with Polatuzumab (periph.neuropathy) were less frequent, with a minor impact on QoL. Therapy started with full dose Bendamustine for 9 pts (75%), with a mean dose of 140 mg; 25% reduced Bendamustine dosage. Less severe toxicities for lower doses of Bendamustine. The ORR was 75%: 3/12 (25%) pts achieved a CR (one with primary refractory disease). SD only for patients in III line of therapy. Median follow-up was 11 months. At April 2025: 4/12 pts still alive without new treatment after PolaBR. 8/12 pts died: 4 PD, 2 other malignancy and 2 sepsis (3 pts in PR, 1 in CR). QOL worsened in 6 patients mainly due to hemato and extrahematological toxicities. Conclusion: PolaBR regimen has been confirmed to be effective in pts with R/R DLBCL. Our real-life experience confirms the toxicity profile of Bendamustine, leading to a worsening of the QoL. The occurrence of grade ≥3 toxicities was associated with a decline in QOL and physical functioning.