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.
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 / F. Merli, S. Luminari, G. Rossi, C. Mammi, L. Marcheselli, A. Ferrari, M. Spina, A. Tucci, C. Stelitano, I. Capodanno, A. Fragasso, L. Baldini, C. Bottelli, E. Montechiarello, S. Fogazzi, C. Lamorgese, L. Cavalli, M. Federico. - In: LEUKEMIA & LYMPHOMA. - ISSN 1042-8194. - 55:1(2014 Jan), pp. 38-43. [10.3109/10428194.2013.788176]
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
L. Baldini;
2014
Abstract
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.Pubblicazioni consigliate
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