Cancer Res Treat.  2018 Apr;50(2):590-598. 10.4143/crt.2017.172.

Multicenter Retrospective Analysis of Clinical Characteristics, Treatment Patterns, and Outcomes in Very Elderly Patients with Diffuse Large B-Cell Lymphoma: The Korean Cancer Study Group LY16-01

• Choi JH
• Kim TM
• Kim HJ
• Koh SA
• Mun YC
• Kang HJ
• Jung YH
• Shim H
• Chong SY
• Sun DS
• Lee S
• Park BB
• Kwon JH
• Nam SH
• Yi JH
• Yuh YJ
• Jin JY
• Han JJ
• Kim SH

• KMID: 2411147
• DOI: http://doi.org/10.4143/crt.2017.172

Abstract

PURPOSE
The treatment strategy for elderly patients older than 80 years with diffuse large B-cell lymphoma (DLBCL) has not been established because of poor treatment tolerability and lack of data.
MATERIALS AND METHODS
This multicenter retrospective study was conducted to investigate clinical characteristics, treatment patterns and outcomes of patients older than 80 years who were diagnosed with DLBCL at 19 institutions in Korea between 2005 and 2016.
RESULTS
A total of 194 patients were identified (median age, 83.3 years). Of these, 114 patients had an age-adjusted International Prognostic Index (aaIPI) score of 2-3 and 48 had a Charlson index score of 4 or more. R-CHOP was given in 124 cases, R-CVP in 13 cases, other chemotherapy in 17 cases, radiation alone in nine cases, and surgery alone in two cases. Twenty-nine patients did not undergo any treatment. The median number of chemotherapy cycles was three. Only 37 patients completed the planned treatment cycles. The overall response rate from 105 evaluable patients was 90.5% (complete response, 41.9%). Twentynine patients died due to treatment-related toxicities (TRT). Thirteen patients died due to TRT after the first cycle. Median overall survival was 14.0 months. The main causes of death were disease progression (30.8%) and TRT (27.1%). In multivariate analysis, overall survival was affected by aaIPI, hypoalbuminemia, elevated creatinine, and treatment.
CONCLUSION
Age itself should not be a contraindication to treatment. However, since elderly patients show higher rates of TRT due to infection, careful monitoring and dose modification of chemotherapeutic agents is needed.

Keyword

Diffuse large B-cell lymphoma; Aged; Infection

MeSH Terms

Aged*
B-Lymphocytes*
Cause of Death
Creatinine
Disease Progression
Drug Therapy
Humans
Hypoalbuminemia
Korea
Lymphoma, B-Cell*
Multivariate Analysis
Retrospective Studies*
Creatinine

Figure

• 

  Fig. 1. Diagram of treatment and response for the patients who received chemotherapy. R-CHOP, rituximab, cyclophosphamide, adriamycin, vincristine, and prednisone; NE, not evaluable; CR, complete response; PR, partial response; SD, stable disease; PD, progressive disease.

• 

  Fig. 2. Kaplan-Meier plots of overall survival in 194 patients (A) and according to treatment (B). Overall survival in 154 patients who received chemotherapy according to treatment regimen (C) and number of chemotherapy cycles (D).

Reference

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