Clinical characteristics, treatment patterns and outcomes of patients older than 80 years diagnosed with DLBCL in China over a 10-year period

Abstract

Purpose: The treatment strategy for elderly patients older than 80 years with DLBCL has not been defined yet because of poor treatment tolerability and lack of data. The aim of this trial was to retrospectively investigate clinical characteristics, treatment patterns and outcomes of patients older than 80 years diagnosed with DLBCL in China over a 10-year period. Methods: This trial comprised 57 patients, aged ≥ 80 years, who were initial diagnosed as diffuse large B-cell lymphoma from 2007 to 2017. They received at least four cycles of reduced-dose R-CHOP21 (Rituximab 375 mg/m2 day 0, Cyclophosphamide 400 mg/m2 day1, Epirubicin 35 mg/m2 day 1, Vincristine 1 mg day 1, and Prednisone 50 mg/m2 days 1–5). An observational population-based, cohort study was performed. Results: The median age was 82.5 years (range 80–90 years) and the overall response rate was 73.7%. With a median 36.4-month follow-up, 2-year overall survival (OS) and 2-year progression-free survival were 74.3% and 70.9%, respectively. Using rigorous multivariate analysis, we concluded that NCCN-IPI ≥ 5 was the only predictive poor prognostic factor. Conclusions: High response rate was concluded on very elderly DLBCL patients (≥ 80 years old) with reduced-dose R-CHOP. However, the very elderly patients with NCCN-IPI score ≥ 5 would lead to poor outcome.