DIFFUSE LARGE B-CELL LYMPHOMA IN THE ELDERLY: REAL-WORLD OUTCOMES OF IMMUNOCHEMOTHERAPY IN ASIAN POPULATION
(Abstract release date: 05/19/16)
EHA Library. Lee J. 06/09/16; 134642; PB1742
Dr. Jeong-Ok Lee
Contributions
Contributions
Abstract
Abstract: PB1742
Type: Publication Only
Background
The International Prognostic Index (IPI) has been the primary scoring system for predicting the survival in diffuse large B-cell lymphoma (DLBCL). However, the validity of IPI in the era of immunochemotherapy is somewhat uncertain, and the age cut-off for defining “elderly” patients remains especially controversial. Moreover, elderly DLBCL patients frequently do not receive adequate treatment, compromising the chance of complete remission.
Aims
We sought to evaluate real-life outcomes of immunochemotherapy in elderly DLBCL patients from a homogenous Asian population.
Methods
This was a single-center, retrospective study of 192 DLBCL patients over 60 years of age treated with first line rituximab – cyclophosphamide, doxorubicin, vincristine, and prednisone between May 2004 and July 2014. Treatment schedule, adverse events and survival outcomes were analyzed overall and by four age groups (over 60 to 64, 65 to 69, 70 to 74, 75 and above).
Results
Patients of 75 years of age and older were associated with significantly lower complete remission (CR) rate (86.5% vs. 81.4% vs. 82.0% vs. 51%; P<0.001) and higher treatment related mortality (TRM) (5.4% vs. 9.3% vs. 13.1% vs. 33.3%; P=0.001). Advanced age was also related to dose reductions (24.3% vs. 39.5% vs. 73.8% vs. 100%; P<0.001) and less likelihood of completing planned chemotherapy cycle (73% vs. 79.1% vs. 78.7% vs. 51%, P=0.005). Significantly poorer progression free survival (PFS) (3-year PFS rate, 45.9% vs. 44.2% vs. 44.3% vs. 11.8%; P=0.043) and overall survival (OS) (3-year OS rate, 64.9% vs. 58.1 vs. 55.7% vs. 23.5%; P<0.001) were observed for patients aged ≥75 years old. Multivariate regression analyses identified age ≥75 and initial ECOG performance status as potential risk factors associated with OS.
Conclusion
In conclusion, elderly patients <75 years old or those with better performance status were tolerable to standard immunochemotherapy, with acceptable survival profiles. In Asian elderly DLBCL population, 75 years seems to be judicious cut-off age for predicting the treatment outcomes. Treating patients aged ≥75 years requires more innovative therapy options and not just dose reductions.
Session topic: E-poster
Keyword(s): Chemotherapy, Diffuse large B cell lymphoma, Elderly
Type: Publication Only
Background
The International Prognostic Index (IPI) has been the primary scoring system for predicting the survival in diffuse large B-cell lymphoma (DLBCL). However, the validity of IPI in the era of immunochemotherapy is somewhat uncertain, and the age cut-off for defining “elderly” patients remains especially controversial. Moreover, elderly DLBCL patients frequently do not receive adequate treatment, compromising the chance of complete remission.
Aims
We sought to evaluate real-life outcomes of immunochemotherapy in elderly DLBCL patients from a homogenous Asian population.
Methods
This was a single-center, retrospective study of 192 DLBCL patients over 60 years of age treated with first line rituximab – cyclophosphamide, doxorubicin, vincristine, and prednisone between May 2004 and July 2014. Treatment schedule, adverse events and survival outcomes were analyzed overall and by four age groups (over 60 to 64, 65 to 69, 70 to 74, 75 and above).
Results
Patients of 75 years of age and older were associated with significantly lower complete remission (CR) rate (86.5% vs. 81.4% vs. 82.0% vs. 51%; P<0.001) and higher treatment related mortality (TRM) (5.4% vs. 9.3% vs. 13.1% vs. 33.3%; P=0.001). Advanced age was also related to dose reductions (24.3% vs. 39.5% vs. 73.8% vs. 100%; P<0.001) and less likelihood of completing planned chemotherapy cycle (73% vs. 79.1% vs. 78.7% vs. 51%, P=0.005). Significantly poorer progression free survival (PFS) (3-year PFS rate, 45.9% vs. 44.2% vs. 44.3% vs. 11.8%; P=0.043) and overall survival (OS) (3-year OS rate, 64.9% vs. 58.1 vs. 55.7% vs. 23.5%; P<0.001) were observed for patients aged ≥75 years old. Multivariate regression analyses identified age ≥75 and initial ECOG performance status as potential risk factors associated with OS.
Conclusion
In conclusion, elderly patients <75 years old or those with better performance status were tolerable to standard immunochemotherapy, with acceptable survival profiles. In Asian elderly DLBCL population, 75 years seems to be judicious cut-off age for predicting the treatment outcomes. Treating patients aged ≥75 years requires more innovative therapy options and not just dose reductions.
Session topic: E-poster
Keyword(s): Chemotherapy, Diffuse large B cell lymphoma, Elderly
Abstract: PB1742
Type: Publication Only
Background
The International Prognostic Index (IPI) has been the primary scoring system for predicting the survival in diffuse large B-cell lymphoma (DLBCL). However, the validity of IPI in the era of immunochemotherapy is somewhat uncertain, and the age cut-off for defining “elderly” patients remains especially controversial. Moreover, elderly DLBCL patients frequently do not receive adequate treatment, compromising the chance of complete remission.
Aims
We sought to evaluate real-life outcomes of immunochemotherapy in elderly DLBCL patients from a homogenous Asian population.
Methods
This was a single-center, retrospective study of 192 DLBCL patients over 60 years of age treated with first line rituximab – cyclophosphamide, doxorubicin, vincristine, and prednisone between May 2004 and July 2014. Treatment schedule, adverse events and survival outcomes were analyzed overall and by four age groups (over 60 to 64, 65 to 69, 70 to 74, 75 and above).
Results
Patients of 75 years of age and older were associated with significantly lower complete remission (CR) rate (86.5% vs. 81.4% vs. 82.0% vs. 51%; P<0.001) and higher treatment related mortality (TRM) (5.4% vs. 9.3% vs. 13.1% vs. 33.3%; P=0.001). Advanced age was also related to dose reductions (24.3% vs. 39.5% vs. 73.8% vs. 100%; P<0.001) and less likelihood of completing planned chemotherapy cycle (73% vs. 79.1% vs. 78.7% vs. 51%, P=0.005). Significantly poorer progression free survival (PFS) (3-year PFS rate, 45.9% vs. 44.2% vs. 44.3% vs. 11.8%; P=0.043) and overall survival (OS) (3-year OS rate, 64.9% vs. 58.1 vs. 55.7% vs. 23.5%; P<0.001) were observed for patients aged ≥75 years old. Multivariate regression analyses identified age ≥75 and initial ECOG performance status as potential risk factors associated with OS.
Conclusion
In conclusion, elderly patients <75 years old or those with better performance status were tolerable to standard immunochemotherapy, with acceptable survival profiles. In Asian elderly DLBCL population, 75 years seems to be judicious cut-off age for predicting the treatment outcomes. Treating patients aged ≥75 years requires more innovative therapy options and not just dose reductions.
Session topic: E-poster
Keyword(s): Chemotherapy, Diffuse large B cell lymphoma, Elderly
Type: Publication Only
Background
The International Prognostic Index (IPI) has been the primary scoring system for predicting the survival in diffuse large B-cell lymphoma (DLBCL). However, the validity of IPI in the era of immunochemotherapy is somewhat uncertain, and the age cut-off for defining “elderly” patients remains especially controversial. Moreover, elderly DLBCL patients frequently do not receive adequate treatment, compromising the chance of complete remission.
Aims
We sought to evaluate real-life outcomes of immunochemotherapy in elderly DLBCL patients from a homogenous Asian population.
Methods
This was a single-center, retrospective study of 192 DLBCL patients over 60 years of age treated with first line rituximab – cyclophosphamide, doxorubicin, vincristine, and prednisone between May 2004 and July 2014. Treatment schedule, adverse events and survival outcomes were analyzed overall and by four age groups (over 60 to 64, 65 to 69, 70 to 74, 75 and above).
Results
Patients of 75 years of age and older were associated with significantly lower complete remission (CR) rate (86.5% vs. 81.4% vs. 82.0% vs. 51%; P<0.001) and higher treatment related mortality (TRM) (5.4% vs. 9.3% vs. 13.1% vs. 33.3%; P=0.001). Advanced age was also related to dose reductions (24.3% vs. 39.5% vs. 73.8% vs. 100%; P<0.001) and less likelihood of completing planned chemotherapy cycle (73% vs. 79.1% vs. 78.7% vs. 51%, P=0.005). Significantly poorer progression free survival (PFS) (3-year PFS rate, 45.9% vs. 44.2% vs. 44.3% vs. 11.8%; P=0.043) and overall survival (OS) (3-year OS rate, 64.9% vs. 58.1 vs. 55.7% vs. 23.5%; P<0.001) were observed for patients aged ≥75 years old. Multivariate regression analyses identified age ≥75 and initial ECOG performance status as potential risk factors associated with OS.
Conclusion
In conclusion, elderly patients <75 years old or those with better performance status were tolerable to standard immunochemotherapy, with acceptable survival profiles. In Asian elderly DLBCL population, 75 years seems to be judicious cut-off age for predicting the treatment outcomes. Treating patients aged ≥75 years requires more innovative therapy options and not just dose reductions.
Session topic: E-poster
Keyword(s): Chemotherapy, Diffuse large B cell lymphoma, Elderly
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