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Outcome of patients older than 80 years with diffuse large B-cell lymphoma (DLBCL) treated with "standard" immunochemotherapy: A large retrospective study from 4 institutions

Stefania Gobba, Alden A Moccia, Wiebke Gulden-Sala, Annarita Conconi, Stefan Diem, Luciano Cascione, Gloria Iacoboni, Gloria Margiotta-Casaluci, Kathrin Aprile Von Hohenstaufen, Anastasios Stathis, Felicitas Hitz, Graziella Pinotti, Gianluca Gaidano & Emanuele Zucca

abstract Little information is available on the very elderly patients with diffuse large B-cell lymphoma (DLBCL). We performed a retrospective analysis of 281 patients >80 years old with newly diagnosed DLBCL treated in 4 referral institutions in Switzerland and Northern Italy. Primary end points were overall survival, progression-free survival, and cause-specific survival. Systemic chemotherapy was given to 239 patients, and 119 of them received rituximab in their initial treatment. At a median follow-up of 5.5 years, 5-year progression-free survival was 26% (95% confidence interval [CI], 20-32%), 5-year overall survival was 31% (95% CI, 25-37%), and 5-year cause-specific survival was 48% (95% CI, 41-55%) for the entire cohort. Rituximab and/or anthracyclines as part of initial treatment were associated with improved outcome. Cause-specific survival in patients receiving both agents approximated 60% at 5 years. At multivariate analysis, rituximab use maintained a significant prognostic impact after controlling for age, performance status, stage, haemoglobin, and lactate dehydrogenase levels. The International Prognostic Index as well as the more recently proposed revised-International Prognostic Index and National Comprehensive Cancer Center Network-International Prognostic Index could discriminate patients with significantly different outcomes. Albeit very elderly and potentially frail, there may be a potential for cure in fit DLBCL patients ≥80 years old. Accurate selection of patients able to tolerate proper immunochemotherapy is crucial.
   
citation Gobba S, Moccia A A, Gulden-Sala W, Conconi A, Diem S, Cascione L, Iacoboni G, Margiotta-Casaluci G, Aprile von Hohenstaufen K, Stathis A, Hitz F, Pinotti G, Gaidano G, Zucca E. Outcome of patients older than 80 years with diffuse large B-cell lymphoma (DLBCL) treated with "standard" immunochemotherapy: A large retrospective study from 4 institutions. Hematol Oncol 2017;.
   
type journal paper/review (English)
date of publishing 16-06-2017
journal title Hematol Oncol
ISSN electronic 1099-1069
PubMed 28621491
DOI 10.1002/hon.2447