A retrospective analysis of real-world outcomes of elderly Chinese patients with diffuse large B-cell lymphoma

• Published in: Chinese medical journal 2019-08, Vol.132 (15), p.1807-1814
• Main Authors: Liu, Peng, Han, Ying, Jiang, Shi-Yu, He, Xiao-Hui, Qin, Yan, Gui, Lin, Zhou, Sheng-Yu, Zhou, Li-Qiang, Yang, Jian- Liang, Yang, Sheng, Wen, Ting-Yu, Shi, Yuan-Kai
• Format: Article
• Language: English
• Subjects: Age; Aged; Antineoplastic Agents, Immunological - therapeutic use; Cancer therapies; Chemotherapy; Cyclophosphamide - therapeutic use; Disease; Doxorubicin - therapeutic use; Humans; Immunotherapy; L-Lactate Dehydrogenase - metabolism; Lymphoma; Lymphoma, Large B-Cell, Diffuse - drug therapy; Lymphoma, Large B-Cell, Diffuse - metabolism; Lymphoma, Large B-Cell, Diffuse - mortality; Medical prognosis; Middle Aged; Monoclonal antibodies; Multivariate analysis; Older people; Original; Patients; Prednisone - therapeutic use; Progression-Free Survival; Retrospective Studies; Rituximab - therapeutic use; Targeted cancer therapy; Vincristine - therapeutic use
• ISSN: 0366-6999; 2542-5641
• DOI: 10.1097/CM9.0000000000000354

Elderly patients with diffuse large B-cell lymphoma (DLBCL) have a worse prognosis than younger patients, and the optimal treatment strategy for this group remains controversial. We conducted a retrospective analysis to investigate the clinical features and outcomes of elderly patients (>60 years) and to assess the impact of clinical and molecular factors on outcome in this age group. From April 2006 to December 2012, a total of 349 elderly patients with DLBCL from the National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences, and Peking Union Medical College were included in this analysis. Patients were further divided into two age groups (61-69 years and ≥70 years). We compared clinical characteristics and outcomes between groups. Of 349 total patients, 204 (58.5%) were aged 61 to 69 years, and 145 (41.5%) patients were aged 70 years or older. Except for the Eastern Cooperative Oncology Group performance status, clinical characteristics were comparable between the two groups. With a median follow-up of 82 (range, 1-129) months, the 5-year overall survival (OS) and progression-free survival (PFS) rates were 51.9% and 45.8%, respectively. The 5-year OS rates for patients aged 61 to 69 years and those over 70 years were 58.3% and 42.8% (P = 0.007), respectively, and the 5-year PFS rates were 51.0% and 38.6% (P = 0.034). Treatment regimens including rituximab provided a higher 5-year OS rate (63.1% vs. 37.1%, P