Survival benefit associated with treating follicular lymphoma in patients 80 years or older. Issue 1 (January 2020)

• Record Type: Journal Article
• Authors: Albarmawi, Husam; Onukwugha, Eberechukwu; Keating, Karen N.; Appukkuttan, Sreevalsa; Yared, Jean
• Is Part Of: Journal of geriatric oncology. Volume 11:Issue 1(2020)
• Page Start: 55
• Page End: 61
• Publication Date: 2020-01
• Subjects: Follicular lymphoma -- Geriatric oncology -- Survival analysis -- Cancer treatment; Geriatric oncology -- Periodicals; Neoplasms -- Periodicals; Aged -- Periodicals; Geriatric oncology; Electronic journals; Periodicals; 618.976994005
• DOI: 10.1016/j.jgo.2019.10.003
• Languages: English
• ISSNs: 1879-4068

Abstract

Abstract: Objectives: To evaluate the overall survival benefit associated with follicular lymphoma (FL)-directed therapy among patients diagnosed with FL at 80+ years. Patients and methods: This retrospective cohort study utilized the linked Surveillance, Epidemiology and End Results-Medicare dataset to identify patients 80+ years, diagnosed with FL between 2000 and 2013. We identified FL-directed treatments based on published guidelines. We utilized a propensity-score matched sample to compare treated and untreated groups who had similar observed characteristics. We reported the median overall survival time and the 3-year restricted mean survival time (RMST) of the study groups as well as the hazard ratio (HR) of death associated with treatment receipt. Results: We identified 3705 older patients with FL (mean [SD] age, 84 [3.6] years). Over a median follow-up of 2.9 years, 68% of the sample received FL-directed therapy and the most common regimen was rituximab monotherapy ( N = 768, 21%). The matched sample included 2306 patients. The median overall survival for the treated group was 4.31 years (95% confidence interval [CI], 4.00–4.61) compared to 2.86 years (95% CI, 2.59–3.16) for the untreated group. The 3-year RMST for the treated group was 2.36 years (95% CI, 2.30–2.41), while it was 2.05 years (95% CI, 1.98–2.11) for the untreated group. Treatment was associated with a 23% reduction in the hazards of death (HR: 0.77, 95% CI: 0.70–0.85; p < .001). Conclusion: FL-directed therapy was associated with improved survival among patients diagnosed with FL at 80+ years. These findings can support treatment decision-making for individuals diagnosed with FL at older ages.