Multicenter retrospective analysis of clinical characteristics, treatment patterns, and outcomes in very elderly patients with diffuse large B-cell lymphoma: The Korean cancer study group LY16-01

Jung Hye Choi, Tae Min Kim, Hyo Jung Kim, Sung Ae Koh, Yeung Chul Mun, Hye Jin Kang, Yun Hwa Jung, Hyeok Shim, So Young Chong, Der Sheng Sun, Soonil Lee, Byeong Bae Park, Jung Hye Kwon, Seung Hyun Nam, Jun Ho Yi, Young Jin Yuh, Jong Youl Jin, Jae Joon Han, Seok Hyun Kim

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Abstract

Purpose The treatment strategy for elderly patients older than 80 years with diffuse large B-cell lymphoma (DLBCL) has not been established because of poor treatment tolerability and lack of data. Materials and Methods This multicenter retrospective study was conducted to investigate clinical characteristics, treatment patterns and outcomes of patients older than 80 years who were diagnosed with DLBCL at 19 institutions in Korea between 2005 and 2016. Results A total of 194 patients were identified (median age, 83.3 years). Of these, 114 patients had an age-adjusted International Prognostic Index (aaIPI) score of 2-3 and 48 had a Charlson index score of 4 or more. R-CHOP was given in 124 cases, R-CVP in 13 cases, other chemotherapy in 17 cases, radiation alone in nine cases, and surgery alone in two cases. Twenty-nine patients did not undergo any treatment. The median number of chemotherapy cycles was three. Only 37 patients completed the planned treatment cycles. The overall response rate from 105 evaluable patients was 90.5% (complete response, 41.9%). Twentynine patients died due to treatment-related toxicities (TRT). Thirteen patients died due to TRT after the first cycle. Median overall survival was 14.0 months. The main causes of death were disease progression (30.8%) and TRT (27.1%). In multivariate analysis, overall survival was affected by aaIPI, hypoalbuminemia, elevated creatinine, and treatment. Conclusion Age itself should not be a contraindication to treatment. However, since elderly patients show higher rates of TRT due to infection, careful monitoring and dose modification of chemotherapeutic agents is needed.

Original languageEnglish
Pages (from-to)590-598
Number of pages9
JournalCancer Research and Treatment
Volume50
Issue number2
DOIs
StatePublished - 2018 Apr 1

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Lymphoma, Large B-Cell, Diffuse
Neoplasms
Therapeutics
Drug Therapy
Hypoalbuminemia
Survival
Korea
Multicenter Studies
Disease Progression
Cause of Death
Creatinine
Multivariate Analysis
Retrospective Studies
Radiation

Keywords

  • Aged
  • Diffuse large B-cell lymphoma
  • Infection

Cite this

Choi, Jung Hye ; Kim, Tae Min ; Kim, Hyo Jung ; Koh, Sung Ae ; Mun, Yeung Chul ; Kang, Hye Jin ; Jung, Yun Hwa ; Shim, Hyeok ; Chong, So Young ; Sun, Der Sheng ; Lee, Soonil ; Park, Byeong Bae ; Kwon, Jung Hye ; Nam, Seung Hyun ; Yi, Jun Ho ; Yuh, Young Jin ; Jin, Jong Youl ; Han, Jae Joon ; Kim, Seok Hyun. / Multicenter retrospective analysis of clinical characteristics, treatment patterns, and outcomes in very elderly patients with diffuse large B-cell lymphoma : The Korean cancer study group LY16-01. In: Cancer Research and Treatment. 2018 ; Vol. 50, No. 2. pp. 590-598.
@article{aef83ee3f2854683baa71ed5ba3a1a81,
title = "Multicenter retrospective analysis of clinical characteristics, treatment patterns, and outcomes in very elderly patients with diffuse large B-cell lymphoma: The Korean cancer study group LY16-01",
abstract = "Purpose The treatment strategy for elderly patients older than 80 years with diffuse large B-cell lymphoma (DLBCL) has not been established because of poor treatment tolerability and lack of data. Materials and Methods This multicenter retrospective study was conducted to investigate clinical characteristics, treatment patterns and outcomes of patients older than 80 years who were diagnosed with DLBCL at 19 institutions in Korea between 2005 and 2016. Results A total of 194 patients were identified (median age, 83.3 years). Of these, 114 patients had an age-adjusted International Prognostic Index (aaIPI) score of 2-3 and 48 had a Charlson index score of 4 or more. R-CHOP was given in 124 cases, R-CVP in 13 cases, other chemotherapy in 17 cases, radiation alone in nine cases, and surgery alone in two cases. Twenty-nine patients did not undergo any treatment. The median number of chemotherapy cycles was three. Only 37 patients completed the planned treatment cycles. The overall response rate from 105 evaluable patients was 90.5{\%} (complete response, 41.9{\%}). Twentynine patients died due to treatment-related toxicities (TRT). Thirteen patients died due to TRT after the first cycle. Median overall survival was 14.0 months. The main causes of death were disease progression (30.8{\%}) and TRT (27.1{\%}). In multivariate analysis, overall survival was affected by aaIPI, hypoalbuminemia, elevated creatinine, and treatment. Conclusion Age itself should not be a contraindication to treatment. However, since elderly patients show higher rates of TRT due to infection, careful monitoring and dose modification of chemotherapeutic agents is needed.",
keywords = "Aged, Diffuse large B-cell lymphoma, Infection",
author = "Choi, {Jung Hye} and Kim, {Tae Min} and Kim, {Hyo Jung} and Koh, {Sung Ae} and Mun, {Yeung Chul} and Kang, {Hye Jin} and Jung, {Yun Hwa} and Hyeok Shim and Chong, {So Young} and Sun, {Der Sheng} and Soonil Lee and Park, {Byeong Bae} and Kwon, {Jung Hye} and Nam, {Seung Hyun} and Yi, {Jun Ho} and Yuh, {Young Jin} and Jin, {Jong Youl} and Han, {Jae Joon} and Kim, {Seok Hyun}",
year = "2018",
month = "4",
day = "1",
doi = "10.4143/crt.2017.172",
language = "English",
volume = "50",
pages = "590--598",
journal = "Cancer Research and Treatment",
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number = "2",

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Choi, JH, Kim, TM, Kim, HJ, Koh, SA, Mun, YC, Kang, HJ, Jung, YH, Shim, H, Chong, SY, Sun, DS, Lee, S, Park, BB, Kwon, JH, Nam, SH, Yi, JH, Yuh, YJ, Jin, JY, Han, JJ & Kim, SH 2018, 'Multicenter retrospective analysis of clinical characteristics, treatment patterns, and outcomes in very elderly patients with diffuse large B-cell lymphoma: The Korean cancer study group LY16-01', Cancer Research and Treatment, vol. 50, no. 2, pp. 590-598. https://doi.org/10.4143/crt.2017.172

Multicenter retrospective analysis of clinical characteristics, treatment patterns, and outcomes in very elderly patients with diffuse large B-cell lymphoma : The Korean cancer study group LY16-01. / Choi, Jung Hye; Kim, Tae Min; Kim, Hyo Jung; Koh, Sung Ae; Mun, Yeung Chul; Kang, Hye Jin; Jung, Yun Hwa; Shim, Hyeok; Chong, So Young; Sun, Der Sheng; Lee, Soonil; Park, Byeong Bae; Kwon, Jung Hye; Nam, Seung Hyun; Yi, Jun Ho; Yuh, Young Jin; Jin, Jong Youl; Han, Jae Joon; Kim, Seok Hyun.

In: Cancer Research and Treatment, Vol. 50, No. 2, 01.04.2018, p. 590-598.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Multicenter retrospective analysis of clinical characteristics, treatment patterns, and outcomes in very elderly patients with diffuse large B-cell lymphoma

T2 - The Korean cancer study group LY16-01

AU - Choi, Jung Hye

AU - Kim, Tae Min

AU - Kim, Hyo Jung

AU - Koh, Sung Ae

AU - Mun, Yeung Chul

AU - Kang, Hye Jin

AU - Jung, Yun Hwa

AU - Shim, Hyeok

AU - Chong, So Young

AU - Sun, Der Sheng

AU - Lee, Soonil

AU - Park, Byeong Bae

AU - Kwon, Jung Hye

AU - Nam, Seung Hyun

AU - Yi, Jun Ho

AU - Yuh, Young Jin

AU - Jin, Jong Youl

AU - Han, Jae Joon

AU - Kim, Seok Hyun

PY - 2018/4/1

Y1 - 2018/4/1

N2 - Purpose The treatment strategy for elderly patients older than 80 years with diffuse large B-cell lymphoma (DLBCL) has not been established because of poor treatment tolerability and lack of data. Materials and Methods This multicenter retrospective study was conducted to investigate clinical characteristics, treatment patterns and outcomes of patients older than 80 years who were diagnosed with DLBCL at 19 institutions in Korea between 2005 and 2016. Results A total of 194 patients were identified (median age, 83.3 years). Of these, 114 patients had an age-adjusted International Prognostic Index (aaIPI) score of 2-3 and 48 had a Charlson index score of 4 or more. R-CHOP was given in 124 cases, R-CVP in 13 cases, other chemotherapy in 17 cases, radiation alone in nine cases, and surgery alone in two cases. Twenty-nine patients did not undergo any treatment. The median number of chemotherapy cycles was three. Only 37 patients completed the planned treatment cycles. The overall response rate from 105 evaluable patients was 90.5% (complete response, 41.9%). Twentynine patients died due to treatment-related toxicities (TRT). Thirteen patients died due to TRT after the first cycle. Median overall survival was 14.0 months. The main causes of death were disease progression (30.8%) and TRT (27.1%). In multivariate analysis, overall survival was affected by aaIPI, hypoalbuminemia, elevated creatinine, and treatment. Conclusion Age itself should not be a contraindication to treatment. However, since elderly patients show higher rates of TRT due to infection, careful monitoring and dose modification of chemotherapeutic agents is needed.

AB - Purpose The treatment strategy for elderly patients older than 80 years with diffuse large B-cell lymphoma (DLBCL) has not been established because of poor treatment tolerability and lack of data. Materials and Methods This multicenter retrospective study was conducted to investigate clinical characteristics, treatment patterns and outcomes of patients older than 80 years who were diagnosed with DLBCL at 19 institutions in Korea between 2005 and 2016. Results A total of 194 patients were identified (median age, 83.3 years). Of these, 114 patients had an age-adjusted International Prognostic Index (aaIPI) score of 2-3 and 48 had a Charlson index score of 4 or more. R-CHOP was given in 124 cases, R-CVP in 13 cases, other chemotherapy in 17 cases, radiation alone in nine cases, and surgery alone in two cases. Twenty-nine patients did not undergo any treatment. The median number of chemotherapy cycles was three. Only 37 patients completed the planned treatment cycles. The overall response rate from 105 evaluable patients was 90.5% (complete response, 41.9%). Twentynine patients died due to treatment-related toxicities (TRT). Thirteen patients died due to TRT after the first cycle. Median overall survival was 14.0 months. The main causes of death were disease progression (30.8%) and TRT (27.1%). In multivariate analysis, overall survival was affected by aaIPI, hypoalbuminemia, elevated creatinine, and treatment. Conclusion Age itself should not be a contraindication to treatment. However, since elderly patients show higher rates of TRT due to infection, careful monitoring and dose modification of chemotherapeutic agents is needed.

KW - Aged

KW - Diffuse large B-cell lymphoma

KW - Infection

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U2 - 10.4143/crt.2017.172

DO - 10.4143/crt.2017.172

M3 - Article

C2 - 28602052

AN - SCOPUS:85044919250

VL - 50

SP - 590

EP - 598

JO - Cancer Research and Treatment

JF - Cancer Research and Treatment

SN - 1598-2998

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