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. 2011 Jul;137(7):1079-84.
doi: 10.1007/s00432-010-0973-x. Epub 2011 Jan 11.

Charlson Comorbidity Index is an independent prognostic factor among elderly patients with diffuse large B-cell lymphoma

Yujin Kobayashi  1 , Katsuhiro Miura, Atsuko Hojo, Yoshihiro Hatta, Toshitake Tanaka, Daisuke Kurita, Noriyoshi Iriyama, Sumiko Kobayashi, Jin Takeuchi
Affiliations

Charlson Comorbidity Index is an independent prognostic factor among elderly patients with diffuse large B-cell lymphoma

Yujin Kobayashi et al. J Cancer Res Clin Oncol. 2011 Jul.

Abstract

Purpose: The clinical outcome for elderly patients with diffuse large B-cell lymphoma (DLBCL) has improved. However, the management of elderly patients with cancer is frequently complicated by their coexisting disorders. The aim of this study was to evaluate the correlation between comorbid medical status and clinical outcome among elderly patients with DLBCL.

Methods: We retrospectively analyzed all patients over 65 years old with newly diagnosed DLBCL from 2001 to 2008 in our institution. To assess their comorbid medical status, we calculated Charlson Comorbidity Index (CCI) of each patient without considering primary disease and then divided them into low CCI (0 or 1) or high CCI group (2 or more).

Results: A total of 80 patients from age of 66-90 years (median 73 years) were analyzed. Seventy-two patients (90%) were treated with cyclophosphamide-, doxorubicin-, vincristine-, and prednisone (CHOP)-based chemotherapy, and 14 patients (18%) were assigned to high CCI. The overall survival (OS) rate at 3 years for all patients was 70%, with significant difference between good and poor risk patients in revised International Prognostic Index (IPI) (90 vs. 45%, P < 0.0001). Multivariate analysis revealed high CCI was associated with worse OS, while independent of other prognostic factors consisting IPI (hazard ratio 4.44, 95% confidence interval [1.63-11.3], P = 0.0045). In addition, high CCI group was significantly inferior to low CCI group for overall response rate (93 vs. 64% P = 0.0158) and 3-year OS (85 vs. 55% P = 0.0026), respectively.

Conclusions: Among elderly DLBCL, high CCI was independently associated with worse outcome. Novel discrete strategies for these deteriorated patients are therefore warranted.

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Conflict of interest statement

We have nothing to disclose other than follows.

Figures

Fig. 1
Fig. 1
Kaplan–Meier curves of overall survival (OS) for elderly patients with diffuse large B-cell lymphoma. OS curves of 80 patients (a) and relation to revised international prognostic index (r-IPI) good risk versus poor risk (b). OS curves according to low Charlson Comorbidity Index (CCI) (CCI = 0 or 1) versus high CCI (CCI ≥ 2) (c)
See this image and copyright information in PMC

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