Association of the Geriatric 8 with treatment intensity and prognosis in older patients with diffuse large B-cell lymphoma

被引:11
作者
Lee, Shin [1 ,2 ]
Fujita, Kei [1 ,2 ]
Morishita, Tetsuji [3 ]
Oiwa, Kana [2 ,4 ]
Tsukasaki, Hikaru [2 ,5 ]
Negoro, Eiju [2 ]
Hara, Takeshi [1 ]
Tsurumi, Hisashi [1 ]
Ueda, Takanori [1 ,2 ]
Yamauchi, Takahiro [2 ]
机构
[1] Matsunami Gen Hosp, Dept Hematol, Dendai 185-1 Kasamatsu Cho, Gifu 5016062, Japan
[2] Univ Fukui, Fac Med Sci, Dept Hematol & Oncol, Fukui, Japan
[3] Kyoto Univ, Grad Sch Med, Dept Healthcare Econ & Qual Management, Yoshida Konoe Cho, Kyoto, Japan
[4] Nagoya City Univ, Dept Hematol & Oncol, Nagoya, Aichi, Japan
[5] Fukui Red Cross Hosp, Dept Hematol, Fukui, Japan
关键词
Geriatric; 8; relative dose intensity; restricted cubic spline; diffuse large B‐ cell lymphoma; real world; ELDERLY-PATIENTS; DOSE INTENSITY; R-CHOP; SURVIVAL; CHEMOTHERAPY; OUTCOMES; IMPACT; CARE;
D O I
10.1111/bjh.17554
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Because of the heterogeneity among older patients with diffuse large B-cell lymphoma (DLBCL), the establishment of an easy-to-use geriatric assessment tool is an unmet need. We verified the impact of the Geriatric 8 (G8) on treatment stratification and overall survival (OS). We conducted a retrospective, multicentre analysis of older patients (>= 65 years) with DLBCL. The primary endpoint was OS. The total average relative dose intensity (tARDI) was defined as the average delivered dose intensity divided by the planned dose intensity through all cycles. A total of 451 patients were diagnosed with DLBCL from 2007 to 2017, and 388 patients received standard regimens. A multivariate Cox model confirmed that the G8 was a significant predictor of OS (hazard ratio 0 center dot 88, 95% confidence interval 0 center dot 828-0 center dot 935). A Cox model with restricted cubic spline showed a linear association between the G8 and the mortality risk. The G8 had a significant impact on OS in elderly patients with DLBCL. The upper limit of tARDI for standard regimens to improve OS might be appropriate at >= 80% for patients with high G8 scores and 60% for patients with low G8 scores. However, the standard regimens should be given to all patients regardless of the G8 score to improve OS.
引用
收藏
页码:325 / 335
页数:11
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