Department of Medicine, University of Minnesota, Veterans Affairs Medical Center, Minneapolis.
Memorial Sloan-Kettering Cancer Center, New York City, USA.
Ann Oncol. 2015 Jun;26(6):1058-1068. doi: 10.1093/annonc/mdv018. Epub 2015 Jan 29.
Diffuse large B-cell lymphoma (DLBCL) is a treatable and potentially curable malignancy that is increasing in prevalence in the elderly. Until recently, older patients with this malignancy were under-represented on clinical treatment trials, so optimal therapeutic approaches for these patients were generally extrapolated from the treatment of younger patients with this disorder. Because of heightened toxicity concerns, older patients were sometimes given reduced dose therapy, potentially negatively impacting outcome. Geriatric considerations including functional status and comorbidities often were not accounted for in treatment decisions. Because of these issues as well as the lack of treatment guidelines for the elderly population, the International Society of Geriatric Oncology convened an expert panel to review DLBCL treatment in the elderly and develop consensus guidelines for therapeutic approaches in this patient population. The following treatment guidelines address initial DLBCL therapy, in both limited and advanced stage disease, as well as approaches to the relapsed and refractory patient.
弥漫性大 B 细胞淋巴瘤 (DLBCL) 是一种可治疗且有潜在治愈可能的恶性肿瘤，在老年人中的发病率正在上升。直到最近，患有这种恶性肿瘤的老年患者在临床治疗试验中代表性不足，因此这些患者的最佳治疗方法通常是从年轻患者的治疗中推断出来的。由于毒性问题更加严重，老年患者有时会接受减少剂量的治疗，这可能会对预后产生负面影响。治疗决策中通常没有考虑到老年人的功能状态和合并症等老年因素。由于这些问题以及缺乏针对老年人群的治疗指南，国际老年肿瘤学会召集了一个专家小组，审查老年人弥漫性大 B 细胞淋巴瘤的治疗方法，并为该患者群体制定治疗方法的共识指南。以下治疗指南针对局限性和晚期疾病的初始弥漫性大 B 细胞淋巴瘤治疗，以及复发和难治性患者的治疗方法。
