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. Issue 1 (January 2014)

• Record Type: Journal Article
• Authors: Merli, Francesco; Luminari, Stefano; Rossi, Giuseppe; Mammi, Caterina; Marcheselli, Luigi; Ferrari, Angela; Spina, Michele; Tucci, Alessandra; Stelitano, Caterina; Capodanno, Isabella; Fragasso, Alberto; Baldini, Luca; Bottelli, Chiara; Montechiarello, Elisa; Fogazzi, Stefano; Lamorgese, Cinzia; Cavalli, Lara; Federico, Massimo
• Is Part Of: Leukemia & lymphoma. Volume 55:Issue 1(2014:Jan.)
• Page Start: 38
• Page End: 43
• Publication Date: 2014-01
• Subjects: Leukemia -- Periodicals; Lymphomas -- Periodicals; 616.99419
• DOI: 10.3109/10428194.2013.788176
• Languages: English
• ISSNs: 1042-8194

Abstract

<abstract> <title>Abstract</title> <p>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 (<italic>p</italic> = 0.005) and the presence of respiratory comorbidity (<italic>p</italic> = 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; <italic>p</italic> &lt; 0.001). CGA is a valid tool to prospectively identify frail subjects among elderly patients with DLBCL.</p> </abstract>