Outcome of frail elderly patients with diffuse large B-cell lymphoma prospectively identified by Comprehensive Geriatric Assessment: results from a study of the Fondazione Italiana Linfomi

被引：68

作者：

Merli, Francesco ^{[1
]}

Luminari, Stefano ^{[2
]}

Rossi, Giuseppe ^{[3
]}

Mammi, Caterina ^{[1
]}

Marcheselli, Luigi ^{[2
]}

Ferrari, Angela ^{[1
]}

Spina, Michele ^{[4
]}

Tucci, Alessandra ^{[3
]}

Stelitano, Caterina ^{[5
]}

Capodanno, Isabella ^{[1
]}

Fragasso, Alberto ^{[6
]}

Baldini, Luca ^{[7
]}

Bottelli, Chiara ^{[3
]}

Montechiarello, Elisa ^{[5
]}

Fogazzi, Stefano ^{[3
]}

Lamorgese, Cinzia ^{[3
]}

Cavalli, Lara ^{[3
]}

Federico, Massimo ^{[2
]}

机构：

[1] Arcispedale Santa Maria Nuova, Hematol Unit, Ist Ricovero & Cura Carattere Sci, I-42123 Reggio Emilia, Italy

[2] Univ Modena & Reggio Emilia, Dept Hematol & Oncol, Modena, Italy

[3] Spedali Civil Brescia, Div Hematol, I-25125 Brescia, Italy

[4] Natl Canc Inst, Div Med Oncol A, Aviano, Italy

[5] Azienda Osped Bianchi Melacrino Morelli, Dept Hematol, Reggio Di Calabria, Italy

[6] Osped Madonna Grazie, Hematol Unit, Dept Internal Med, Matera, Italy

[7] Univ Milan, Ca Granda Hosp Maggiore Policlin, IRCCS Fdn, Hematol Unit 1, Milan, Italy

来源：

LEUKEMIA & LYMPHOMA | 2014年 / 55卷 / 01期

关键词：

Diffuse large B-cell lymphoma (DLBCL); elderly patients; frail patients; Comprehensive Geriatric Assessment (CGA); chemotherapy; rituximab; NON-HODGKINS-LYMPHOMA; TRIAL; CHEMOTHERAPY; RITUXIMAB; DOXORUBICIN; CANCER; CHOP; MANAGEMENT; RICOVER-60;

D O I：

10.3109/10428194.2013.788176

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

In 2003 the Fondazione Italiana Linfomi (FIL) started a clinical research program for investigating initial treatment of frail elderly patients with diffuse large B-cell lymphoma (DLBCL) identified by Comprehensive Geriatric Assessment (CGA). From 2003 to 2006, 334 elderly patients underwent CGA assessment, and 99 patients were classified as frail. Frail patients had a median age of 78 years, stage III-IV disease in 62% and age-adjusted International Prognostic Index (aaIPI) of 2-3 in 53%. Treatment consisted of several different regimens according to physician discretion. After a median follow-up of 36 months, 5-year overall survival (OS) was 28%. In multivariate analysis, aaIPI 2-3 (p=0.005) and the presence of respiratory comorbidity (p=0.044) were the only factors that showed independent correlation with OS. Frail patients had a poorer outcome compared with fit patients also if they were treated with rituximab-containing combination chemotherapy (hazard ratio 2.37, 95% confidence interval 1.48-3.78; p<0.001). CGA is a valid tool to prospectively identify frail subjects among elderly patients with DLBCL.

引用

页码：38 / 43

页数：6

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