Department of Hematology, Federation of National Public Service Personnel Mutual Aid Associations Tachikawa Hospital, 4-2-22 Nishiki-cho, Tachikawa-shi, Tokyo, 190-8531, Japan.
Ann Hematol. 2019 Mar;98(3):669-678. doi: 10.1007/s00277-018-3551-y. Epub 2018 Nov 15.
The proportion of elderly patients with diffuse large B cell lymphoma (DLBCL) appears to be increasing, with outcomes varying widely because of the patients' heterogeneity. Geriatric assessment is used to predict prognosis in elderly patients with DLBCL, but the utility of two simple screening tools for patients with DLBCL, the Flemish version of the Triage Risk Screening Tool (fTRST) and G8, has remained to be elucidated. We retrospectively assessed patients using fTRST and G8, and evaluated the impacts of the scores on survival outcomes in older patients with newly diagnosed DLBCL. A total of 59 patients aged 65 years or older and who were diagnosed with DLBCL were included. The median age was 77 years (range, 65-91 years), and the initial treatments were R-CHOP (63%) and R-THPCOP (31%). The estimated 2-year overall survival (OS) rate was significantly lower in patients with abnormal fTRST scores (≥ 2; N = 17) than in those with normal fTRST scores (< 2; N = 42): (50.5% (95% CI, 22.7-73.0%) vs. 82.2% (95% CI, 63.8-91.8%), P = 0.007). The estimated 2-year OS rate was significantly lower also in patients with abnormal G8 scores (≤ 14; N = 38) than in those with normal G8 scores (> 14; N = 21): (66.1% (95% CI, 46.7-79.5%) vs. 86.8% (95% CI, 55.7-96.7%), P = 0.03, respectively). These associations were independently significant after adjusting for other significant factors by multivariate analysis. These results suggest that the easy-to-use geriatric screening tools, fTRST and G8, have strong prognostic value for OS in older patients with DLBCL.
老年弥漫大 B 细胞淋巴瘤(DLBCL)患者的比例似乎在增加,由于患者的异质性,其预后差异很大。老年评估用于预测 DLBCL 老年患者的预后,但 Flemish 版 Triage Risk Screening Tool(fTRST)和 G8 这两种用于 DLBCL 患者的简单筛查工具的效用仍有待阐明。我们回顾性地使用 fTRST 和 G8 评估了患者,并评估了这些评分对新诊断的 DLBCL 老年患者生存结果的影响。共纳入 59 名年龄在 65 岁及以上的 DLBCL 患者。中位年龄为 77 岁(范围为 65-91 岁),初始治疗为 R-CHOP(63%)和 R-THPCOP(31%)。fTRST 评分异常(≥2;N=17)患者的 2 年总生存(OS)率明显低于 fTRST 评分正常(<2;N=42)患者(50.5%(95%CI,22.7-73.0%)vs. 82.2%(95%CI,63.8-91.8%),P=0.007)。G8 评分异常(≤14;N=38)患者的 2 年 OS 率也明显低于 G8 评分正常(>14;N=21)患者(66.1%(95%CI,46.7-79.5%)vs. 86.8%(95%CI,55.7-96.7%),P=0.03)。多因素分析调整其他重要因素后,这些关联具有统计学意义。这些结果表明,易于使用的老年综合评估工具 fTRST 和 G8 对 DLBCL 老年患者的 OS 具有很强的预后价值。