Introduction

Diffuse large B cell lymphoma (DLBCL) has an increasing incidence in elderly patients with poorer prognosis than in younger patients. Clinicians should clearly identify the characteristics and prognostic factors of elderly patients. We analyzed the outcome of elderly DLBCL patients, especially factors affecting survival in real-life clinical practice.

Materials and Methods

The data of 330 DLBCL patients at our center were retrospectively evaluated by dividing three groups; younger than 65 years, between 65 -79 years, and 80 years and older. We examined the factors affecting survival in DLBCL patients ≥ 65 years old.

Results

The median age of the patients was 61 years (range 16-87). 192 (58.2%) of our patients were younger than 65 years old, 112 (33.9%) were between 65-79 years, and 26 (7.9%) patients were 80 years old or older. The median follow-up was 15 (1-120) months. Median PFS was 38 months in the 65-79 years group, ten months in the ≥ 80 years group; meanwhile, median OS was 43 months in the 65-79 years group, 25 months in the ≥80 years group. The number of patients who relapsed within 12 months of the first-line treatment was 69 (35.9%) in the <65 years group, it was 60 (53.6%) in 65-79 years group, and 22 (84.6%) in ≥80 years group (p < 0.001). The median OS was 9 (7.1- 10.9) months in DLBCL patients older than 65 years old who relapsed within 12 months. Early relapse, failure to achieve CR after first-line chemotherapy, and high IPI score were associated with poor survival in patients ≥ 65 years old (p:0.001).

Conclusion

Advancing age was a poor prognostic factor for survival of DLBCL. Relapsing within the first year, or failure to achieve complete remission were associated with poorer survival of the elderly DLBCL patients. R-CHOP is the standard treatment in DLBCL, and the best responses are obtained regardless of age. Due to difficulty in receiving standard treatments, novel treatment modalities are needed for better outcomes in elderly patients with DLBCL.

中文翻译：

---

影响老年弥漫性大 B 细胞淋巴瘤患者生存的因素

介绍

弥漫性大 B 细胞淋巴瘤 (DLBCL) 在预后较差的老年患者中的发病率高于年轻患者。临床医生应明确老年患者的特征和预后因素。我们分析了老年 DLBCL 患者的结局，尤其是在现实临床实践中影响生存的因素。

材料和方法

将我中心330例DLBCL患者的资料分为三组进行回顾性评价；65 岁以下、65 -79 岁之间和 80 岁及以上。我们检查了影响 ≥ 65 岁 DLBCL 患者生存的因素。

结果

患者的中位年龄为 61 岁（范围 16-87）。我们的患者中有 192 名 (58.2%) 年龄小于 65 岁，112 名 (33.9%) 年龄在 65-79 岁之间，26 名 (7.9%) 患者年龄在 80 岁或以上。中位随访时间为 15 (1-120) 个月。65-79岁组中位PFS为38个月，≥80岁组为10个月；同时，65-79 岁组的中位 OS 为 43 个月，≥80 岁组为 25 个月。一线治疗12个月内复发的患者数<65岁组69例（35.9%），65-79岁组60例（53.6%），≥22例（84.6%） 80 岁组 (p < 0.001)。在 12 个月内复发的 65 岁以上 DLBCL 患者的中位 OS 为 9 (7.1-10.9) 个月。早期复发，一线化疗后未能达到 CR，

结论

高龄是 DLBCL 生存的不良预后因素。第一年内复发或未能达到完全缓解与老年 DLBCL 患者的较差生存相关。R-CHOP 是 DLBCL 的标准治疗方法，无论年龄大小，都能获得最佳反应。由于难以接受标准治疗，需要新的治疗方式来改善老年 DLBCL 患者的预后。