Are oldest old patients with diffuse large B-cell lymphoma different than their younger counterparts: Results from the REALYSA real-life cohort

IF 2.4 3区医学 Q3 ONCOLOGY

Cancer Epidemiology Pub Date : 2025-04-05 DOI:10.1016/j.canep.2025.102812

Christelle Cantrelle , Aurélien Belot , Alain Monnereau , Fontanet Bijou , Cédric Rossi , Hadia Khebbeb Hafirassou , Ludovic Fouillet , Pierre Soubeyran , Hervé Ghesquières , Loic Ysebaert , Sandra Le Guyader Peyrou , Angéline Galvin

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引用次数: 0

Abstract

Introduction

Over a half of diffuse large B-cell lymphoma (DLBCL) cases are diagnosed in adults aged 65 years and older. Older adults are a heterogeneous group, and few studies reported differences in care management and survival in the oldest old. We aimed to describe characteristics, care management, and survival of older adults aged 60 and over included in the REal-world dAta in LYmphoma and Survival in Adults (REALYSA) study.

Materials

and methods: Patients newly diagnosed with DLBCL, aged over 60 years, included in REALYSA cohort between 2018/11 and 2021/12 and receiving therapy (RCHOP/miniRCHOP/Other) were included. Sociodemographic, living area and clinical characteristics, as well as the type of care center and pathway during the first year after diagnosis were described by age (60–69 y/70–79 y/≥80 y). Survival was described using Kaplan-Meier curves, the Cox model for adjusted survival, and net survival (Pohar-Perme estimator).

Results

A total of 560 DLBCL patients with a median age at diagnosis of 72 years (IQR=67–77) were included. R-CHOP was the main curative treatment in patients aged 60–79, and R-miniCHOP in the oldest old. More than half of the patients were male, married or in a relationship, living in urban and low deprived area. With increasing age, the proportion of patients with performance status 0–1 or no Charlson comorbidity at diagnosis decreased. Two thirds of patients were diagnosed at advanced stage with comparable trends between age groups. However, the oldest patients were more likely to have high-risk disease and geriatric frailty at diagnosis. One-year net survival, in contrast to OS (91 %vs 95 % and 75 % for each age group), showed no significant reduction in survival for 80 + (93 %, 100 % and 87 % for each age group).

Conclusion

As the fastest-growing age group in developed countries, the oldest old require a special attention and further work on this population is needed.

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导言超过一半的弥漫大 B 细胞淋巴瘤（DLBCL）病例是在 65 岁及以上的成年人中确诊的。老年人是一个异质性群体，很少有研究报告老年人在护理管理和生存率方面存在差异。我们旨在描述REal-world dAta in LYmphoma and Survival in Adults（REALYSA）研究中60岁及以上老年人的特征、护理管理和生存情况：纳入2018/11至2021/12年间REALYSA队列中新诊断出的60岁以上DLBCL患者，并接受治疗（RCHOP/miniRCHOP/其他）。按年龄（60-69 岁/70-79 岁/≥80 岁）描述了社会人口学、生活区域和临床特征，以及确诊后第一年的护理中心类型和路径。结果共纳入了 560 例 DLBCL 患者，诊断时的中位年龄为 72 岁（IQR=67-77）。R-CHOP是60-79岁患者的主要治疗方法，R-miniCHOP是最年长患者的主要治疗方法。半数以上患者为男性，已婚或有伴侣，居住在城市和低贫困地区。随着年龄的增长，诊断时表现为 0-1 或无 Charlson 合并症的患者比例有所下降。三分之二的患者被诊断为晚期，各年龄组之间的趋势相当。然而，年龄最大的患者在确诊时更有可能患有高危疾病和老年虚弱症。一年净存活率与OS（各年龄组分别为91%、95%和75%）相比，80岁以上患者的存活率没有明显下降（各年龄组分别为93%、100%和87%）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cancer Epidemiology 医学-肿瘤学

CiteScore

4.50

自引率

3.80%

发文量

200

审稿时长

39 days

期刊介绍： Cancer Epidemiology is dedicated to increasing understanding about cancer causes, prevention and control. The scope of the journal embraces all aspects of cancer epidemiology including: • Descriptive epidemiology • Studies of risk factors for disease initiation, development and prognosis • Screening and early detection • Prevention and control • Methodological issues The journal publishes original research articles (full length and short reports), systematic reviews and meta-analyses, editorials, commentaries and letters to the editor commenting on previously published research.