Department of Hematology and Oncology, University of Fukui, Fukui, Japan.
Department of Hematology and Oncology, Nagoya City University, Aichi, Japan.
Oncologist. 2021 Mar;26(3):215-223. doi: 10.1002/onco.13641. Epub 2020 Dec 30.
The management of severe adverse events (AEs) is important in safely and effectively providing chemotherapy to older adults with diffuse large B-cell lymphoma (DLBCL). However, reports on simple and DLBCL-specific predictive models for treatment-related toxicity in elderly individuals are scarce. The aim of this study was to examine the usefulness of Geriatric 8 (G8) in predicting treatment-related severe AEs, nonhematological toxicity, and febrile neutropenia in older adults with DLBCL in real-world practice.
We conducted a multicenter, retrospective study on 398 consecutive patients with DLBCL (aged ≥65 years) who received standard therapy at three centers in Japan (University of Fukui Hospital, the Fukui Prefectural Hospital, and the Japanese Red Cross Fukui Hospital), between 2007 and 2017.
Multivariate logistic analysis demonstrated that the G8 score was an independent predictive factor for severe AEs. Moreover, a logistic regression model with restricted cubic spline showed a nonlinear association between the incidence of severe AEs and the G8 score. According to receiver operating characteristic analysis, the most discriminative cutoff value of the G8 for the incidence of severe AEs was 11, with an area under the curve value of 0.670. AEs occurred most often in the first course of chemotherapy and decreased as the course progressed.
The G8 score, an easy-to-use geriatric assessment tool, can be a useful prediction model of treatment-related severe AEs during standard therapy in older adults with DLBCL.
In older patients with diffuse large B-cell lymphoma (DLBCL), to accurately predict the risk of severe adverse events (AEs) in advance is essential for safe and effective treatment. This study demonstrated that the Geriatric 8 score, a simple and established geriatric assessment tool, indicated a high predictive ability for occurrence of therapy-related severe AEs in elderly patients with DLBCL who were treated with standard treatment.
在为老年弥漫性大 B 细胞淋巴瘤（DLBCL）患者安全有效地提供化疗时，严重不良事件（AE）的管理很重要。然而，关于老年人治疗相关毒性的简单和 DLBCL 特异性预测模型的报告很少。本研究旨在检查老年 8 项（G8）在预测老年 DLBCL 患者接受标准治疗时与治疗相关的严重 AE、非血液学毒性和发热性中性粒细胞减少症中的作用。
我们对 2007 年至 2017 年间在日本三个中心（福井大学医院、福井县立医院和日本红十字福井医院）接受标准治疗的 398 例连续 DLBCL 患者（年龄≥65 岁）进行了多中心回顾性研究。
多变量逻辑分析表明，G8 评分是严重 AE 的独立预测因素。此外，具有限制立方样条的逻辑回归模型显示了 G8 评分与严重 AE 发生率之间的非线性关系。根据受试者工作特征分析，G8 对严重 AE 发生率的最佳截断值为 11，曲线下面积值为 0.670。AE 最常发生在第一个化疗疗程中，并随着疗程的进展而减少。
G8 评分是一种易于使用的老年评估工具，可以作为预测老年 DLBCL 患者标准治疗相关严重 AE 的有用模型。
在老年弥漫性大 B 细胞淋巴瘤（DLBCL）患者中，提前准确预测严重不良事件（AE）的风险对于安全有效的治疗至关重要。本研究表明，老年 8 项评分，一种简单而成熟的老年评估工具，对接受标准治疗的老年 DLBCL 患者发生治疗相关严重 AE 的预测能力较高。
