Clinical characteristics and outcomes in diffuse large B cell lymphoma patients aged 70 years and older: a single-center experience with a literature review.
BACKGROUND/AIMS
Among diffuse large B cell lymphoma (DLBCL) patients, determining the appropriate dose and chemotherapy schedule to balance toxicity and efficacy is harder in elderly than in younger patients. Moreover, there are no currently available clinical factors that consistently identify patients who are unfit to receive chemotherapy. Therefore, the clinical characteristics and outcomes of elderly patients with DLBCL and the causes of treatment-related death were investigated in this study.


METHODS
The clinical characteristics and outcomes of 44 elderly (≥ 70 years of age) patients diagnosed with DLBCL between January 2005 and June 2013 were evaluated. Variable clinical data along with the response rate, overall survival (OS), and causes of treatment-related death or treatment interruption were investigated.


RESULTS
The median OS was 18.6 months, and 19 patients completed curative treatment. The mean average relative dose intensity of adriamycin in patients who completed chemotherapy was 0.617, and of these patients, 16 achieved complete remission. Chemotherapy incompletion, infectious complications, ex tranoda l involvement, high lactate dehydrogenase, poor performance status, and low albumin level at diagnosis were related to a shorter OS. However, multivariate analysis revealed that only infections and chemotherapy incompletion were significantly related to poor prognosis. The most common cause of treatment-related death was infection, and patients who had experienced infectious complications tended to have lower albumin levels than those of patients without such complications.


CONCLUSIONS
In the treatment of elderly lymphoma patients, the dose intensity of adriamycin is not as important as it is in young patients. However, in elderly patients, infections are particularly dangerous, especially in patients with low albumin levels.
['Jung|Yun Hwa|YH|', 'Woo|In Sook|IS|', 'Han|Chi Wha|CW|']
D000367:Age Factors D000368:Aged D000369:Aged, 80 and over D000903:Antibiotics, Antineoplastic D000971:Antineoplastic Combined Chemotherapy Protocols D016009:Chi-Square Distribution D003141:Communicable Diseases D018450:Disease Progression D004317:Doxorubicin D005260:Female D015577:Geriatric Assessment D006801:Humans D053208:Kaplan-Meier Estimate D016403:Lymphoma, Large B-Cell, Diffuse D008297:Male D015999:Multivariate Analysis D016016:Proportional Hazards Models D012074:Remission Induction D056910:Republic of Korea D012189:Retrospective Studies D012307:Risk Factors D012709:Serum Albumin D000075462:Serum Albumin, Human D013997:Time Factors D016896:Treatment Outcome
Aged Albumins Infection Lymphoma, large B-cell, diffuse