80岁及以上弥漫性大B细胞淋巴瘤患者合适化疗方案的确定。

Determination of the appropriate chemotherapy for patients aged 80 years or older with diffuse large B cell lymphoma.

作者信息

Kim Min Jung, Cho Junhun, Kim Won Seog, Kim Seok Jin, Yoon Sang Eun

机构信息

Division of Hematology-Oncology, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, South Korea.

Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.

出版信息

Leuk Lymphoma. 2025 Jul;66(7):1264-1275. doi: 10.1080/10428194.2025.2471500. Epub 2025 Mar 3.

Abstract

This is a retrospective study conducted to determine whether there is an optimal regimen for elderly diffuse large B-cell lymphoma (DLBCL) patients. We selected patients aged 80 years or older who received the frontline chemoimmunotherapy of standard-dose rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP), reduced dose of R-CHOP (R-miniCHOP), or rituximab and bendamustine (BR). Patients with standard dose of R-CHOP presented a better overall response rate than those with R-miniCHOP ( = 0.047). However, there was no significant difference in progression-free survival (PFS) or overall survival (OS) among the groups. Eastern Cooperative Oncology Group performance status of 0 or 1, serum albumin ≥3.5 g/dL, early stage, and GCB subtype were the factors associated with superior PFS and OS. In conclusion, no single regimen was found to be superior for elderly DLBCL patients. Rather than selecting regimen depending on sole age, comprehensive evaluation should be done before chemotherapy initiation.

摘要

这是一项回顾性研究,旨在确定老年弥漫性大B细胞淋巴瘤(DLBCL)患者是否存在最佳治疗方案。我们选取了80岁及以上接受标准剂量利妥昔单抗、环磷酰胺、阿霉素、长春新碱和泼尼松(R-CHOP)、减量R-CHOP(R-miniCHOP)或利妥昔单抗与苯达莫司汀(BR)一线化疗免疫治疗的患者。标准剂量R-CHOP组的总缓解率高于R-miniCHOP组(=0.047)。然而,各组之间的无进展生存期(PFS)或总生存期(OS)无显著差异。东部肿瘤协作组体能状态为0或1、血清白蛋白≥3.5 g/dL、早期以及生发中心B细胞(GCB)亚型是与较好的PFS和OS相关的因素。总之,未发现单一治疗方案对老年DLBCL患者具有优越性。不应仅根据年龄选择治疗方案,而应在化疗开始前进行综合评估。

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