估计弥漫大 B 细胞淋巴瘤（DLBCL）中符合移植条件患者的比例：来自德国医院账单数据的启示

Inpatient billing data from all German hospitals in 2024, provided by the Institute for the Hospital Remuneration System (InEK), were analyzed. Cases with the main diagnosis "C83.3" (DLBCL) defined the base population. Applying guideline-based first-line cure rates (60% [minimum]-70% [maximum]), the 2L population size was estimated. Transplant-eligible cases were identified via OPS codes for salvage immunochemotherapies (R-ICE, R-DHAP, R-GDP). The transplant-eligible proportion was calculated by dividing the number of transplant-eligible cases by the estimated 2L population. Sensitivity analyses were performed using data from 2022 and 2023, validating the 2L relapse/refractoriness rate assumption against German real-world claims data, and assessing potential impact of polatuzumab vedotin-related coding bias.

The base population included 32,851 DLBCL cases. Based on cure rate assumptions, the estimated 2L population size ranged from 9,855 (minimum) to 13,140 (maximum). A total of 7,523 cases were identified to have received salvage immunochemotherapy based on coding criteria. This corresponds to a transplant-eligible proportion of patients intended for HD-ASCT of 57% (minimum) and 76% (maximum). Sensitivity analyses yielded a transplant-eligible proportion range of 40% to 54% (2022) and 52% to 69% (2023), 52% when applying the relapse/refractoriness rate from German real-world claims data, and 34% to 46% when excluding polatuzumab vedotin-related cases.

This analysis introduces a method for approximating estimating the distribution of transplant eligibility among DLBCL patients intended for HD-ASCT in the 2L setting using real-world inpatient billing data. The results question the widely assumed balance between transplant-eligible and -ineligible groups, indicating a possible tendency toward a slightly higher proportion of transplant-eligible cases which may be clinically eligible for HD-ASCT.