Clinical value of comprehensive geriatric assessment scoring in predicting the outcome of diffuse large B-cell lymphoma in patients aged 80 years and over
10.3760/cma.j.issn.0254-9026.2019.02.013
- VernacularTitle:老年综合评估积分在高龄弥漫大B细胞淋巴瘤患者中的临床意义
- Author:
Jiangtao LI
1
;
Chunli ZHANG
;
Ru FENG
;
Ting WANG
;
Jiefei BAI
;
Hui LIU
Author Information
1. 北京医院血液科国家老年医学中心
- Keywords:
Lymphoma;
B-cell;
Activities of daily living
- From:
Chinese Journal of Geriatrics
2019;38(2):170-175
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical characteristics of diffuse large B-cell lymphoma (DLBCL) and to evaluated the predictive value of comprehensive geriatric assessment (CGA)in advanced-aged DLBCL patients.Methods A total of 24 patients aged 80 years and over diagnosed with DLBCL in our hospital from March 2010 to July 2017 were enrolled in this study.CGA included three parts:age,activities of daily living(ADL)/instrumental activities of daily living(IADL)and comorbidity evaluated by the cumulative illness rating score for geriatrics(CIRS-G).According to CGA scores,all patients were classified into either the not-applicable group or the frail group.Results There were 10 and 14 patients in the not-applicable group and the frail group,respectively.Twenty-two patients received chemotherapy,and the incidences of toxicity after chemotherapy were comparable between the two groups.Nine patients achieved complete remission (CR),five patients partial remission(PR),and the overall response rate(ORR) was 63.6 %.The not-applicable group seemed to have a higher complete remission rate than the frail group(60.0 % vs.25.0 %,x2=2.764,P =0.192).However,the overall response rates were comparable between the two groups.Treatment-related deaths occurred in 2 and 3 patients(20.0 % vs.25.0 %,x2 =0.078,P =1.000)in the not-applicable and frail groups,respectively.Relapse/progression-related deaths occurred in 3 and 5 patients in the not-applicable and frail groups(30.0% vs.41.7%,x2 =0.321,P =0.675),respectively.The 2-year overall survival rates and progression-free survival rates were 56.3 % versus 35.2 % (x2 =0.635,P =0.426)and 42.2 % versus 16.7 % (x2 =2.156,P =0.142) in the not-applicable and frail groups,respectively.Conclusions Advanced-aged patients with DLBCL have a poor prognosis,which can be predicted by CGA to a certain extent.Further improvement in the current CGA scoring system is still needed to accurately predict the prognosis of DLBCL in advanced-aged patients and to guide treatment.