Comprehensive Geriatric Assessment Is an Essential Tool to Support Treatment Decisions in Elderly Patients With Diffuse Large B-cell Lymphoma: A Prospective Multicenter Evaluation in 173 Patients by the Lymphoma Italian Foundation (FIL)

Leuk Lymphoma. 2015 Apr;56(4):921-6. doi: 10.3109/10428194.2014.953142. Epub 2014 Oct 9.

Abstract

We performed a multicenter study to validate the concept that a simple comprehensive geriatric assessment (CGA) can identify elderly, non-fit patients with diffuse large B-cell lymphoma (DLBCL) in whom curative treatment is not better then palliation, and to analyze potential benefits of treatment modulation after further subdividing the non-fit category by CGA criteria. One hundred and seventy-three patients aged > 69 treated with curative or palliative intent by clinical judgement only were grouped according to CGA into fit (46%), unfit (16%) and frail (38%) categories. Two-year overall survival (OS) was significantly better in fit than in non-fit patients (84% vs. 47%; p < 0.0001). Survival in unfit and frail patients was not significantly different. Curative treatment slightly improved 2-year OS in unfit (75% vs. 45%) but not in frail patients (44% vs. 39%). CGA was confirmed as very efficient in identifying elderly patients with DLBCL who can benefit from a curative approach. Further efforts are needed to better tailor therapies in non-fit patients.

Keywords: Lymphoma and Hodgkin disease; chemotherapeutic approaches; immunotherapy.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Disease-Free Survival
  • Geriatric Assessment / methods*
  • Humans
  • Lymphoma, Large B-Cell, Diffuse / diagnosis*
  • Lymphoma, Large B-Cell, Diffuse / therapy*
  • Multivariate Analysis
  • Palliative Care / methods*
  • Prognosis
  • Prospective Studies
  • Treatment Outcome