Comparison of R‐CHOP‐14 and R‐mini‐CHOP in older adults with diffuse large B‐cell lymphoma—A retrospective multicenter cohort study

• Published in: European journal of haematology 2024-11, Vol.113 (5), p.675-684
• Main Authors: Dilbaz, Zelal Guel, Denker, Sophy, Ankermann, Carla, Bittenbring, Joerg‐Thomas, Kaddu‐Mulindwa, Dominic, Kunte, Ameya S., Hünecke, Sascha, Poeschel, Viola, Stilgenbauer, Stephan, Thurner, Lorenz, Na, Il‐Kang, Bewarder, Moritz, Christofyllakis, Konstantinos
• Format: Article
• Language: English
• Subjects: Age; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Chemotherapy; Cohort analysis; Cyclophosphamide - administration & dosage; Cyclophosphamide - therapeutic use; diffuse large B‐cell lymphoma; dose intensity; Doxorubicin - administration & dosage; Doxorubicin - adverse effects; Doxorubicin - therapeutic use; Female; Humans; Lymphoma; Lymphoma, Large B-Cell, Diffuse - diagnosis; Lymphoma, Large B-Cell, Diffuse - drug therapy; Lymphoma, Large B-Cell, Diffuse - mortality; Male; Prednisone - administration & dosage; Prednisone - therapeutic use; Retrospective Studies; Rituximab - administration & dosage; R‐CHOP‐14; R‐miniCHOP; Statistical analysis; Treatment Outcome; Vincristine - administration & dosage; Vincristine - adverse effects; Vincristine - therapeutic use
• ISSN: 0902-4441; 1600-0609; 1600-0609
• DOI: 10.1111/ejh.14268

Diffuse large B‐cell lymphoma (DLBCL) is the most common lymphoma entity, and its incidence increases with age. There is a paucity of data regarding use of biweekly R‐CHOP (R‐CHOP‐14) in patients ≥80 years of age. We performed a retrospective cohort study of patients with DLBCL aged ≥80 years treated with R‐CHOP‐14 and R‐miniCHOP in two academic tertiary centers in Germany between 01/01/2005 and 12/30/2019. Overall, 79 patients were included. Median age was 84 years (range 80–91). Despite higher CR rates with R‐CHOP‐14 (71.4% vs. 52.4%), no statistically significant difference could be found between patients treated with R‐CHOP‐14 and R‐miniCHOP regarding overall survival (OS) (p = .88, HR 0.94, 95% CI = 0.47–1.90) and progression‐free survival (PFS) (p = .26, HR 0.66, 95% CI = 0.32–1.36). At a median follow‐up of 40 months, the 2‐year OS rates were 56% with R‐CHOP‐14 and 53% with R‐miniCHOP. Two‐year PFS rates were 46% for R‐CHOP‐14 and 50% for R‐mini‐CHOP. Relative dose intensity of chemotherapy did not correlate with OS (p = .72). With the caveat of a retrospective cohort study, we conclude that lacking a difference in OS, R‐miniCHOP should be preferred for most patients with untreated DLBCL aged ≥80 years.