Determination of the appropriate chemotherapy for patients aged 80 years or older with diffuse large B cell lymphoma.

Abstract

This is a retrospective study conducted to determine whether there is an optimal regimen for elderly diffuse large B-cell lymphoma (DLBCL) patients. We selected patients aged 80 years or older who received the frontline chemoimmunotherapy of standard-dose rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP), reduced dose of R-CHOP (R-miniCHOP), or rituximab and bendamustine (BR). Patients with standard dose of R-CHOP presented a better overall response rate than those with R-miniCHOP (p = 0.047). However, there was no significant difference in progression-free survival (PFS) or overall survival (OS) among the groups. Eastern Cooperative Oncology Group performance status of 0 or 1, serum albumin ≥3.5 g/dL, early stage, and GCB subtype were the factors associated with superior PFS and OS. In conclusion, no single regimen was found to be superior for elderly DLBCL patients. Rather than selecting regimen depending on sole age, comprehensive evaluation should be done before chemotherapy initiation.