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RESEARCH PRODUCT

Comprehensive geriatric assessment is an essential tool to support treatment decisions in elderly patients with diffuse large B-cell lymphoma: A prospective multicenter evaluation in 173 patients by the Lymphoma Italian Foundation (FIL)

Paolo PaesanoMaura BrugiatelliMaria Giuseppina CabrasAngelo FamaMichele SpinaAlberto FabbriBenedetta PucciniGiuseppe RossiSalvatrice MancusoLuigi RigacciFlavia SalviPaola RiccomagnoMaurizio MartelliChiara BottelliCaterina StelitanoAlessandra TucciSergio StortiStefano FogazziDaniela DalceggioFrancesco Bertagna

subject

medicine.medical_specialtyCancer ResearchMultivariate analysisLymphomaChemotherapeutic approaches; Immunotherapy; Lymphoma and Hodgkin disease; Hematology; Oncology; Cancer ResearchMEDLINEDisease-Free SurvivalInternal medicineComprehensive Assesment Diffuse large B cell lymphomaAntineoplastic Combined Chemotherapy Protocolsmedicine80 and overLarge B-CellHumansProspective StudiesProspective cohort studyGeriatric AssessmentAgedAged 80 and overChemotherapeutic approachesbusiness.industryPalliative CareGeriatric assessmentHematologymedicine.diseasePrognosisDiffuseSurgeryLymphomaSettore MED/15 - MALATTIE DEL SANGUETreatment OutcomeMulticenter studyOncologyLymphoma and Hodgkin diseaseMultivariate AnalysisTreatment decision makingImmunotherapyLymphoma Large B-Cell DiffusebusinessDiffuse large B-cell lymphoma

description

We performed a multicenter study to validate the concept that a simple comprehensive geriatric assessment (CGA) can identify elderly, non-fit patients with diffuse large B-cell lymphoma (DLBCL) in whom curative treatment is not better then palliation, and to analyze potential benefits of treatment modulation after further subdividing the non-fit category by CGA criteria. One hundred and seventy-three patients aged > 69 treated with curative or palliative intent by clinical judgement only were grouped according to CGA into fit (46%), unfit (16%) and frail (38%) categories. Two-year overall survival (OS) was significantly better in fit than in non-fit patients (84% vs. 47%; p < 0.0001). Survival in unfit and frail patients was not significantly different. Curative treatment slightly improved 2-year OS in unfit (75% vs. 45%) but not in frail patients (44% vs. 39%). CGA was confirmed as very efficient in identifying elderly patients with DLBCL who can benefit from a curative approach. Further efforts are needed to better tailor therapies in non-fit patients.

yearjournalcountryeditionlanguage
2015-01-01
10.3109/10428194.2014.953142http://hdl.handle.net/10807/172552