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What Determines Therapeutic Choices for Elderly Patients With DLBCL? Clinical Findings of a Multicenter Study in Portugal

2014; Elsevier BV; Volume: 14; Issue: 5 Linguagem: Inglês

10.1016/j.clml.2014.01.008

2152-2650

Rute Alvarez, Susana Esteves, Sérgio Chacim, José Pedro Carda, Alexandra Mota, Manuel Guerreiro, Inês Amorim Monteiro Barbosa, Filipa Moita, Adriana Teixeira, Jorge Coutinho, Fernando Prı́ncipe, José Mariz, María Gomes da Silva,

Chronic Lymphocytic Leukemia Research

Age is a negative prognostic factor in lymphomas, and elderly patients are often undertreated because of toxicity concerns. The pattern of treatment in elderly patients with diffuse large B-cell lymphoma (DLBCL) in Portugal has not been previously described.We conducted a multicenter retrospective study including 378 elderly patients with DLBCL receiving alkylating agent-containing regimens between 2003 and 2010. We compared the outcome of patients aged 60 to 79 years with patients > 79 years and analyzed the second group according to treatment.R-CHOP (rituximab, cyclophosphamide, doxorubicin [hydroxydaunorubicin], vincristine [Oncovin], prednisolone) was prescribed in only 60% of patients and was prescribed significantly less in patients > 79 years, despite no significant differences being found in comorbidities between the 2 age groups. Similarly, dose reductions frequently were instituted because of chronologic age and not always because of toxicity. When different regimens were compared, multivariate analysis showed an independent beneficial effect of R-CHOP in treatment outcomes. Additionally, treatment with anthracyclines and rituximab predicted a better progression-free survival (PFS) and time to progression (TTP) in patients > 79 years.This was the first characterization of the clinical care of elderly Portuguese patients with DLBCL. We showed that R-CHOP is effective even in patients > 79 years, emphasizing that treatment decisions based on age alone can compromise treatment efficacy and outcome in fit patients.