老年人弥漫性大b细胞淋巴瘤在资源有限的环境中治疗的结果

IF 1.6 Q3 HEMATOLOGY

Hematology, Transfusion and Cell Therapy Pub Date : 2025-07-01 DOI:10.1016/j.htct.2025.103893

Natasha Ali , Raheel Iftikhar , Zeeshan Khan , Usman Ahmed , Humera Mahmood , Zeba Aziz

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引用次数: 0

摘要

目的老年弥漫性大b细胞淋巴瘤（DLBCL）的治疗具有挑战性。低收入和中等收入国家（LMICs）关于老年DLBCL的数据有限。我们根据患者的社会经济地位分析了DLBCL患者的表现和生存结果。方法：本研究为2015 - 2023年的多中心回顾性研究。我们纳入了176名年龄在60岁或以上的患者。检查的变量包括年龄、性别、亚型、资源环境和接受的治疗。为整个患者队列创建Kaplan-Meier曲线；采用t检验比较均值、无病生存期（DFS）和总生存期（OS），显著性水平为p <；0.05. 采用SPSS 29版进行分析。结果患者中位年龄66岁（范围60 ~ 89岁）。93名（57%）患者在资源有限的环境中接受治疗，而43%的患者在资源增强的环境中接受治疗。ECOG表现得分在2 - 3分之间的占71%。IPI得分中位数为3。51% （n = 81）患者采用RCHOP方案，20% （n = 32）患者采用CHOP方案。21% （n = 38）因复发/难治性疾病而给予挽救性治疗。本组患者均未接受自体干细胞移植巩固治疗。整个队列的OS为12个月，DFS为8个月。OS (33.9% vs. 8.2%；p = 0.00)和DFS (29% vs. 5.9%；P = 0.00)。在强化环境中治疗的患者的中位生存期为1.3年，而在资源有限的环境中为0.4年(p <；0.0001)结论在资源有限的环境中接受治疗的患者生存率较低。早期转诊和纳入利妥昔单抗可改善预后。加强老年评估以及更好的支持性护理至关重要。

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OUTCOMES OF DIFFUSE LARGE B-CELL LYMPHOMA IN OLDER ADULTS TREATED IN RESOURCE-CONSTRAINED SETTINGS

Objective

Treating Diffuse Large B-Cell Lymphoma (DLBCL) in elderly patients is challenging. There is limited data available from Low- and Middle-Income Countries (LMICs) on elderly DLBCL. We analyzed the presentations and survival outcomes of patients with DLBCL according to their socioeconomic status.

Methodology

This was a multicenter retrospective study conducted from 2015 to 2023. We included 176 patients aged 60 years or older. The variables examined were age, gender, subtype, resource environment and treatment received. Kaplan-Meier curve was created for the entire patient cohort; t-test was utilized to compare means, Disease-Free Survival (DFS) and Overall Survival (OS), with a significance level of p < 0.05. Analysis was performed using SPSS version 29.

Results

The median age was 66 years (range: 60–89 years). Ninety-three (57%) patients were treated in limited resource settings, while 43% had enhanced resources. ECOG performance scores between 2 and 3 were present in 71%. Median IPI score was 3. RCHOP regimen was administered to 51% (n = 81) patients, and CHOP regimen to 20% (n = 32) patients. In 21% (n = 38) salvage treatment was given due to relapsed/refractory disease. None of the patients in this group received consolidation with autologous stem cell transplant. The entire cohort’s OS was 12-months, while DFS was 8-months. OS (33.9% vs. 8.2%; p = 0.00) and DFS (29% vs. 5.9%; p = 0.00) were better in patients with enhanced resources. The median DFS of patients treated in enhanced settings was 1.3-years versus 0.4-years in limited resource settings (p < 0.0001)

Conclusion

Survival rates were lower for patients receiving treatment in resource-limited settings. Outcomes can be improved with early referral and inclusion of Rituximab. Enhanced geriatric assessments along with better supportive care is essential.

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