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. 2019 May 3;36(2):81-87.
doi: 10.4274/tjh.galenos.2019.2018.0219. Epub 2019 Feb 6.

Prognostic Factors in Elderly Patients with Diffuse Large B-Cell Lymphoma and Their Treatment Results

Süleyman Cem Adıyaman  1 , İnci Alacacıoğlu  2 , Ayça Ersen Danyeli  3 , Doğuş Türkyılmaz  2 , Ömür Gökmen Sevindik  2 , Fatih Demirkan  2 , Özden Pişkin  2 , Mehmet Ali Özcan  2 , Bülent Ündar  2 , Sermin Özkal  3 , Güner Hayri Özsan  2
Affiliations

Prognostic Factors in Elderly Patients with Diffuse Large B-Cell Lymphoma and Their Treatment Results

Süleyman Cem Adıyaman et al. Turk J Haematol. .

Abstract
in English, Turkish

Objective: Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma (NHL). The treatment of older NHL patients has always been a struggle; however, treatment statistics have begun showing favorable results similar to those of younger DLBCL patients thanks to newer treatment protocols. Here, we analyze the progress of our own elderly DLBCL patients who were followed between 2000 and 2016 in our center.

Materials and methods: Eighty-seven DLBCL patients, who were diagnosed and treated in the Dokuz Eylül University Department of Hematology between 2000 and 2016, were included in this study. Median age was 72 (65-89) years and 13 (14.9%) patients were older than 80 years.

Results: Median follow-up time was 19 months and 45 patients (51.7%) died during the follow-up period. Median overall survival (OS) was 55 months and median progression-free survival was calculated as 27 months. Sixty-three patients (72.4%) received standard R-CHOP therapy. Complete response was seen in 46 (52.9%) patients. The median survival time for patients who had complete response was 136 months (p<0.001); however, OS was not statistically different between older (>80 years) and younger patients (p=0.236).

Conclusion: According to our findings, we think that being able to complete standard R-CHOP therapy is vital for the survival rate of elderly DLBCL patients.

Amaç: Diffüz büyük B hücreli lenfoma (DBBHL), Hodgkin dışı lenfomalar (NHL) arasında en sık görülen tiptir. Yaşlı NHL hastalarının tedavisi genellikle zorlu olmakla beraber günümüzde gelişen tedavi protokolleri ile birlikte yaşlı hastalarda da genç DBBHL hastalarına benzer oranda daha iyimser sonuçlar elde edilmektedir. Bu çalışmaya Dokuz Eylül Üniversitesi Hematoloji Anabilim Dalı’nda 2000-2016 yılları arasında takip ve tedavi edilmiş 87 yaşlı DBBHL hastası dahil edildi.

Gereç ve yöntemler: Yaş ortalaması 72 (65-89), 80 yaşının üzerinde 13 (%14,9) hasta mevcuttu. Ortalama takip süresi 19 ay olup, tüm takip süresinde hastaların 45’inin (%51,7) öldüğü gözlendi.

Bulgular: Ortalama genel sağkalım süresi 55 ay iken progresyonsuz sağkalım süresi 27 ay olarak hesaplandı. Hastaların 63’ünün (%72,4) standart R-CHOP tedavisi almış olduğu görüldü. Ek olarak hastaların 46’sında (%52,9) tam yanıt alındığı gözlendi. Tam yanıt izlenen hastaların ortalama genel sağkalım süresi 136 ay olarak saptandı (p<0,001), ancak, 80 yaş üzeri hastalar ile altındaki hastaların genel sağkalım süreleri arasında anlamlı istatistiksel fark izlenmedi (p=0,236).

Sonuç: Bu veriler ışığında yaşlı DBBHL’li hastalarda standart R-CHOP tedavisinin tamamlanmasının sağkalım süresine önemli etkisi bulunduğunu söyleyebiliriz.

Keywords: Lymphomas; Lymphoid cell neoplasms; B-Cell neoplasms; Non-Hodgkin lymphoma.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest: The authors of this paper have no conflicts of interest, including specific financial interests, relationships, and/or affiliations relevant to the subject matter or materials included.

Figures

Figure 1
Figure 1
Overall survival and age. OS: Overall survival.
Figure 2
Figure 2
Overall survival and immunohistochemical subtypes. OS: Overall survival.
Figure 3
Figure 3
Overall survival and comorbid diseases. OS: Overall survival.
Figure 4
Figure 4
Overall survival and treatment response. OS: Overall survival.
See this image and copyright information in PMC

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