A real-world study of first-line therapy in 280 consecutive Swedish patients ≥80 years with newly diagnosed diffuse large B-cell lymphoma: very elderly (≥85 years) do well on curative intended therapy

Leuk Lymphoma. 2020 Sep;61(9):2136-2144. doi: 10.1080/10428194.2020.1765233. Epub 2020 May 25.


This real-world study investigated outcome of first-line treatment in elderly patients with diffuse large B-cell lymphoma (DLBCL). All (n = 292) new DLBCL patients ≥80 years diagnosed in the Stockholm region from 2000-2015 were included. Median age was 85 years, most had good performance status and low comorbidity score. CHOP (cyclophosphamide/doxorubicin/vincristine/prednisone) was used in 60/230 patients, R-CHOP in 170/230. Only 12% of patients aged 80-84 years and 6% of ≥85 years received full-dose chemotherapy. Infections (≥ grade III) occurred in 49% and 37% in the two age groups, respectively. Addition of rituximab resulted in a similar and significant improvement in both age subsets regarding complete remission, progression-free (PFS) and overall survival (OS). Rituximab, performance status and stage, but not age, were significantly associated with PFS and OS by multivariate analysis. Strictly consecutive patients ≥85 years from a well-defined geographical region responded to and tolerated R-CHOP equally well as patients aged 80-84 years.

Keywords: DLBCL; elderly; first line therapy; real-world.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged, 80 and over
  • Antibodies, Monoclonal, Murine-Derived / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Cyclophosphamide / therapeutic use
  • Disease-Free Survival
  • Doxorubicin / therapeutic use
  • Humans
  • Lymphoma, Large B-Cell, Diffuse* / diagnosis
  • Lymphoma, Large B-Cell, Diffuse* / drug therapy
  • Lymphoma, Large B-Cell, Diffuse* / epidemiology
  • Prednisone / therapeutic use
  • Retrospective Studies
  • Rituximab / therapeutic use
  • Sweden / epidemiology
  • Vincristine / therapeutic use


  • Antibodies, Monoclonal, Murine-Derived
  • Rituximab
  • Vincristine
  • Doxorubicin
  • Cyclophosphamide
  • Prednisone