Diffuse large B-cell lymphoma in elderly patients: A retrospective analysis

• Published in: European journal of internal medicine 2014-07, Vol.25 (6), p.577-582
• Main Authors: Diem, S, Ess, S, Cerny, Th, Früh, M, Hitz, F
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Antibodies, Monoclonal, Murine-Derived - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - administration & dosage; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Cyclophosphamide - administration & dosage; Disease-Free Survival; DLBCL; Doxorubicin - administration & dosage; Elderly; Female; Humans; Internal Medicine; Lymphoma, Large B-Cell, Diffuse - drug therapy; Male; Middle Aged; Multivariate Analysis; Prednisone - administration & dosage; Prognosis; R-CHOP; Registries; Retrospective Studies; Switzerland; Treatment Outcome; Vincristine - administration & dosage
• ISSN: 0953-6205; 1879-0828
• DOI: 10.1016/j.ejim.2014.05.001

Abstract Background Few data on patterns of care and outcomes are available for elderly patients with diffuse large B-cell lymphoma (DLBCL) outside of clinical trials. Methods We identified patients with DLBCL older than 60 years from a regional cancer registry between 2000 and 2010. Based on registry data and chart review, 128 patients from the oncology network of Eastern Switzerland were analysed for patient characteristics, treatment and outcomes of DLBCL. Three age groups were compared: 60–69, 70–79 and over 80 years old. Results Median age was 73 years (range: 60 to 95 years). 52/121 treated patients received 6 cycles of R-CHOP/CHOP, of those 30 (58%), 18 (35%) and 4 (7%) patients were 60–69 years, 70–79 years or older than 80 years respectively, with a significant difference by age group, p = 0.001. Median OS of patients 60–69, 70–79, and 80 years and older receiving 6 cycles of R-CHOP/CHOP were: 54 months, 31 months and 24 months respectively. In comparison, patients receiving other than 6 cycles of R-CHOP/CHOP treatment regimens had a median OS of 22 months, 17 months and 6 months, respectively. In the multivariable analysis other than 6 cycles of R-CHOP/CHOP were significantly associated with poor survival. The risk of dying increased by a mean of 6% for each year of age from age 60 years onwards. Conclusion In conclusion, treatment regimens other than 6 cycles of R-CHOP/CHOP were significant predictors for survival in our oncology network. The possibility of using R-CHOP treatment regimen should be seriously considered in elderly patients with DLBCL.