Abstract
This study aimed to investigate the treatment strategy, prognostic factors, and risk factors of early death in elderly patients (age ≥ 65 years) with diffuse large B-cell lymphoma (DLBCL) in the rituximab era. Data from elderly patients diagnosed with DLBCL between 2008 and 2014 were collected for analysis. Patients who were younger and had a better performance status were more likely to receive intensive frontline treatment. The median progression-free survival (PFS) and overall survival were 15 and 21 months, respectively. Anthracycline-containing chemotherapy achieved a higher remission rate and showed a trend towards better overall survival but a higher risk of severe neutropenia. Multivariate analysis revealed that very old age (≥81 years), a high-risk age-adjusted international prognostic index (aaIPI) score, and bone marrow involvement were associated with poorer PFS and overall survival. Progression of lymphoma was the major cause of death in the study population. In addition, approximately 25% of patients died within 120 days of being diagnosed. The risk factors for early mortality included very old age, a high-risk aaIPI score, and bone marrow involvement. The appearance of symptoms or signs of tumour lysis syndrome at diagnosis was associated with a trend towards early death.
Highlights
With increased life expectancy of the overall population, the number of elderly cancer patients is expected to increase in the coming years[1,2,3]
Previous studies have shown that incorporating rituximab into the conventional chemotherapy of cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP) significantly improves clinical outcomes, including overall survival and progression-free survival (PFS) in patients with DLBCL7,8
We evaluated the treatment strategies, clinical outcomes, and risk factors for early mortality in patients with Diffuse large B-cell lymphoma (DLBCL)
Summary
With increased life expectancy of the overall population, the number of elderly cancer patients is expected to increase in the coming years[1,2,3]. Elderly cancer patients are more likely to suffer from life-threatening chemotherapy-related toxicity or early death due to chronic or weakness-associated diseases and age. It is very important for healthcare professionals to understand the characteristics of this subgroup to ensure that treatment plans are tailored to achieve the best treatment result and to avoid unnecessary side effects. Patients with poorer performance and complicated comorbidities are unlikely to have participated in these trials Another important issue is the occurrence of early death after the diagnosis of cancer or after the start of chemotherapy because elderly patients are more prone to suffer from severe complications of the disease or cancer-related treatment. We elucidated the risk factors for early mortality to help physicians tailor treatment plans to achieve optimal clinical outcomes
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