Contributions
Abstract: PB1871
Type: Publication Only
Background
Indolent B-cell lymphoproliferative neoplasms (B-LPN) are malignant diseases of advanced age. The most common among them, follicular lymphoma (FL), marginal zone lymphoma (MZL) and chronic lymphocytic leukemia (CLL) together represent about 40 % of all B-LPN. However, as indolent B-LPN are most often the slow-growing diseases, an approach 'watch and wait' is often recommended. But, when treatment is necessary, the advanced patients’ age indicate the need for geriatric assessment (GA) in aim to indentify functional, cognitive, social, nutritional and psychological parameters of the general health status. G8 screening tool (G8) is recognized as fast, easy to perform and sensitive test for selecting the group of fit elderly patients capable for curative treatment approach. Although incorporated in routine oncological practice, GA and G8 are not widely evaluated in hematological practice, so far.
Aims
To evaluate the impact of G8 screening tool on clinical outcome and survival of elderly patients with indolent B-LPN s'> The most common among them, follicular lymphoma (FL), marginal zone lymphoma (MZL) and chronic lymphocytic leukemia (CLL) together represent about 40 % of all B-LPN. However, as indolent B-LPN are most often the slow-growing diseases, an approach 'watch and wait' is often recommended. But, when treatment is necessary, the advanced patients’ age indicate the need for geriatric assessment (GA) in aim to indentify functional, cognitive, social, nutritional and psychological parameters of the general health status. G8 screening tool (G8) is recognized as fast, easy to perform and sensitive test for selecting the group of fit elderly patients capable for curative treatment approach. Although incorporated in routine oncological practice, GA and G8 are not widely evaluated in hematological practice, so far.
Methods
Total of 89 consecutive elderly patients (45males and 44 females with median age at diagnosis 74,6 years, range 65-88 years) with indolent B-LPN (24 with FL, 26 with MZL and 39 with CLL) who fulfilled criteria for treatment initiation were included in study. Patients were treated with antracycline, fludarabine or alkylated agents based chemotherapy regimens +/- monoclonal anti-CD20 antibody. Validity of G8 was compared with standard relevant clinical and laboratory parameters.
Results
For all 89 patients median overall survival (OS) was 77 months, and disease free survival (DFS) in 58 (77.3%) patients achieving remission was 25 months. Among laboratory paremeters, hemoglobin, platelet, neutrophil and monocyte count, as well as C-reactive protein, beta-2 microglobulin didn’t influence CR rate, OS and DFS. Elevated lactate dehydrogense was foud significante for CR rate, and low albumin level (<40g/L) for predicting OS. Among clinical parameters age, sex, presence of “B” symptoms, splenomegaly (>13cm), bulky disease (>10cm), extranodal (EN) disease, as well Charlson comorbidity index (CCI; ≤3∕>3), ECOG performance status (PS; <2/≥2) and G8 screening tool (>14/≤14) were evaluated. EN and G8 were found significant for CR rate: and EN, B symptoms, ECOG PS and G8 for OS. Multiplarameter analysis singled out G8 as most sensitive prognostic parameter for both CR (P=0.005;HR 1,343, 95%CI:0.214-2.552) and OS (p=0.018; HR 11,262, 95%CI:1.503-4.400)
Conclusion
According to our experience, the implementation of G8 is good prognostic parameter. Its incorporation into standard hematological indices may help in improving the optimal treatment approach decision in elderly patients.
Session topic: 19. Indolent Non-Hodgkin lymphoma - Clinical
Keyword(s): Elderly, Prognostic factor, Indolent lymphoma
Abstract: PB1871
Type: Publication Only
Background
Indolent B-cell lymphoproliferative neoplasms (B-LPN) are malignant diseases of advanced age. The most common among them, follicular lymphoma (FL), marginal zone lymphoma (MZL) and chronic lymphocytic leukemia (CLL) together represent about 40 % of all B-LPN. However, as indolent B-LPN are most often the slow-growing diseases, an approach 'watch and wait' is often recommended. But, when treatment is necessary, the advanced patients’ age indicate the need for geriatric assessment (GA) in aim to indentify functional, cognitive, social, nutritional and psychological parameters of the general health status. G8 screening tool (G8) is recognized as fast, easy to perform and sensitive test for selecting the group of fit elderly patients capable for curative treatment approach. Although incorporated in routine oncological practice, GA and G8 are not widely evaluated in hematological practice, so far.
Aims
To evaluate the impact of G8 screening tool on clinical outcome and survival of elderly patients with indolent B-LPN s'> The most common among them, follicular lymphoma (FL), marginal zone lymphoma (MZL) and chronic lymphocytic leukemia (CLL) together represent about 40 % of all B-LPN. However, as indolent B-LPN are most often the slow-growing diseases, an approach 'watch and wait' is often recommended. But, when treatment is necessary, the advanced patients’ age indicate the need for geriatric assessment (GA) in aim to indentify functional, cognitive, social, nutritional and psychological parameters of the general health status. G8 screening tool (G8) is recognized as fast, easy to perform and sensitive test for selecting the group of fit elderly patients capable for curative treatment approach. Although incorporated in routine oncological practice, GA and G8 are not widely evaluated in hematological practice, so far.
Methods
Total of 89 consecutive elderly patients (45males and 44 females with median age at diagnosis 74,6 years, range 65-88 years) with indolent B-LPN (24 with FL, 26 with MZL and 39 with CLL) who fulfilled criteria for treatment initiation were included in study. Patients were treated with antracycline, fludarabine or alkylated agents based chemotherapy regimens +/- monoclonal anti-CD20 antibody. Validity of G8 was compared with standard relevant clinical and laboratory parameters.
Results
For all 89 patients median overall survival (OS) was 77 months, and disease free survival (DFS) in 58 (77.3%) patients achieving remission was 25 months. Among laboratory paremeters, hemoglobin, platelet, neutrophil and monocyte count, as well as C-reactive protein, beta-2 microglobulin didn’t influence CR rate, OS and DFS. Elevated lactate dehydrogense was foud significante for CR rate, and low albumin level (<40g/L) for predicting OS. Among clinical parameters age, sex, presence of “B” symptoms, splenomegaly (>13cm), bulky disease (>10cm), extranodal (EN) disease, as well Charlson comorbidity index (CCI; ≤3∕>3), ECOG performance status (PS; <2/≥2) and G8 screening tool (>14/≤14) were evaluated. EN and G8 were found significant for CR rate: and EN, B symptoms, ECOG PS and G8 for OS. Multiplarameter analysis singled out G8 as most sensitive prognostic parameter for both CR (P=0.005;HR 1,343, 95%CI:0.214-2.552) and OS (p=0.018; HR 11,262, 95%CI:1.503-4.400)
Conclusion
According to our experience, the implementation of G8 is good prognostic parameter. Its incorporation into standard hematological indices may help in improving the optimal treatment approach decision in elderly patients.
Session topic: 19. Indolent Non-Hodgkin lymphoma - Clinical
Keyword(s): Elderly, Prognostic factor, Indolent lymphoma