Department of Hematology, Medical Center Leeuwarden , Leeuwarden , The Netherlands.
Leuk Lymphoma. 2014 Mar;55(3):526-32. doi: 10.3109/10428194.2013.810737. Epub 2013 Jul 29.
To assess treatment strategies, toxicity and outcome in very elderly patients (aged ≥ 75 years) diagnosed with diffuse large B-cell lymphoma (DLBCL) in the rituximab era, an observational population-based cohort study was performed. From 103 patients with a median age of 81 years, data of clinical characteristics, treatment, toxicity and outcome were evaluated. Advanced stage DLBCL was documented in 74 patients. In 80 patients chemotherapy was initiated; 70 patients received rituximab, cyclophosphamide, doxorubicin, vincristine and prednisolone (R-CHOP). In this group, 39 patients completed all cycles and 30 patients achieved a complete remission. Severe chemotherapy-related toxicity occurred in 69%. Two-year overall survival was 70% for elderly patients who completed chemotherapy, 28% for those treated with incomplete or suboptimal chemotherapy and 21% for those receiving palliative radiotherapy or supportive care. In conclusion, the ability to complete R-CHOP was associated with better overall survival compared to other treatment strategies at the expense of severe treatment-related toxicity.
为了评估利妥昔单抗时代诊断为弥漫性大 B 细胞淋巴瘤（DLBCL）的非常老年患者（年龄≥75 岁）的治疗策略、毒性和结局，进行了一项观察性基于人群的队列研究。从中位年龄为 81 岁的 103 名患者中，评估了临床特征、治疗、毒性和结局的数据。74 名患者有晚期 DLBCL 记录。80 名患者开始化疗；70 名患者接受利妥昔单抗、环磷酰胺、多柔比星、长春新碱和泼尼松（R-CHOP）。在这组患者中，39 名患者完成了所有周期，30 名患者达到完全缓解。严重的化疗相关毒性发生率为 69%。完成化疗的老年患者 2 年总生存率为 70%，接受不完全或不充分化疗的患者为 28%，接受姑息性放疗或支持性治疗的患者为 21%。总之，与其他治疗策略相比，完成 R-CHOP 的能力与更好的总生存率相关，但代价是严重的治疗相关毒性。
