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Cancer Res Treat. 2018 Apr;50(2):590-598. doi: 10.4143/crt.2017.172. Epub 2017 Jun 9.

Multicenter Retrospective Analysis of Clinical Characteristics, Treatment Patterns, and Outcomes in Very Elderly Patients with Diffuse Large B-Cell Lymphoma: The Korean Cancer Study Group LY16-01.

Author information

1
Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea.
2
Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
3
Department of Internal Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.
4
Department of Internal Medicine, Yeungnam University Medical Center, Daegu, Korea.
5
Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea.
6
Department of Internal Medicine, Korea Institute of Radiological and Medical Sciences, Korea Cancer Center Hospital, Seoul, Korea.
7
Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
8
Department of Internal Medicine, Wonkwang University School of Medicine, Iksan, Korea.
9
Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea.
10
Department of Internal Medicine, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Uijeongbu, Korea.
11
Department of Internal Medicine, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Korea.
12
Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
13
Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
14
Department of Internal Medicine, Veterans Health Service Medical Center, Seoul, Korea.
15
Department of Internal Medicine, Chung-Ang University Hospital, Seoul, Korea.
16
Department of Internal Medicine, Inje University Sanggye Paik Hospital, Seoul, Korea.
17
Department of Internal Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea.
18
Devision of Hematology-Oncology, Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea.
19
Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea.

Abstract

PURPOSE:

The treatment strategy for elderly patients older than 80 years with diffuse large B-cell lymphoma (DLBCL) has not been established because of poor treatment tolerability and lack of data.

MATERIALS AND METHODS:

This multicenter retrospective study was conducted to investigate clinical characteristics, treatment patterns and outcomes of patients older than 80 years who were diagnosed with DLBCL at 19 institutions in Korea between 2005 and 2016.

RESULTS:

A total of 194 patients were identified (median age, 83.3 years). Of these, 114 patients had an age-adjusted International Prognostic Index (aaIPI) score of 2-3 and 48 had a Charlson index score of 4 or more. R-CHOP was given in 124 cases, R-CVP in 13 cases, other chemotherapy in 17 cases, radiation alone in nine cases, and surgery alone in two cases. Twenty-nine patients did not undergo any treatment. The median number of chemotherapy cycles was three. Only 37 patients completed the planned treatment cycles. The overall response rate from 105 evaluable patientswas 90.5% (complete response, 41.9%). Twentynine patients died due to treatment-related toxicities (TRT). Thirteen patients died due to TRT after the first cycle. Median overall survival was 14.0 months. The main causes of death were disease progression (30.8%) and TRT (27.1%). In multivariate analysis, overall survival was affected by aaIPI, hypoalbuminemia, elevated creatinine, and treatment.

CONCLUSION:

Age itself should not be a contraindication to treatment. However, since elderly patients show higher rates of TRT due to infection, careful monitoring and dose modification of chemotherapeutic agents is needed.

KEYWORDS:

Aged; Diffuse large B-cell lymphoma; Infection

PMID:
28602052
PMCID:
PMC5912125
DOI:
10.4143/crt.2017.172
[Indexed for MEDLINE]
Free PMC Article

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