Sonnevi, Kristina;
Wästerlid, Tove;
Melén, Christopher M.;
Harrysson, Sara;
Smedby, Karin E.;
Wahlin, Björn E.
Survival of very elderly patients with diffuse large B‐cell lymphoma according to treatment intensity in the immunochemotherapy era: a Swedish Lymphoma Register study
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Medientyp:
E-Artikel
Titel:
Survival of very elderly patients with diffuse large B‐cell lymphoma according to treatment intensity in the immunochemotherapy era: a Swedish Lymphoma Register study
Beteiligte:
Sonnevi, Kristina;
Wästerlid, Tove;
Melén, Christopher M.;
Harrysson, Sara;
Smedby, Karin E.;
Wahlin, Björn E.
Erschienen:
Wiley, 2021
Erschienen in:British Journal of Haematology
Sprache:
Englisch
DOI:
10.1111/bjh.16737
ISSN:
0007-1048;
1365-2141
Entstehung:
Anmerkungen:
Beschreibung:
<jats:title>Summary</jats:title><jats:p>Diffuse large B‐cell lymphoma (DLBCL) incidence rises with increasing age. Rituximab‐anthracycline‐based regimens offer a potential cure but also risks of adverse events, especially in the elderly. Using Swedish registers, we conducted a nationwide, population‐based study of DLBCL in the very elderly. We obtained information on clinical characteristics, residence, comorbidity, therapy and survival for the 1194 patients aged ≥80 years diagnosed in Sweden 2007–2014. To address selection bias, we also investigated treatment differences between Sweden’s Healthcare Regions and whether there were survival differences between the Regions. The 2‐year overall and relative survivals were better in patients aged ≥80 years given treatment with curative intent (54%; 64%) than low‐intensity (26%; 33%), or palliative treatment (6%; 7%). The fraction of patients treated with curative intent varied between the Healthcare Regions (45–76%). Survival was significantly inferior in Regions with few patients treated with curative intent (multivariable hazard ratio 1.3, 95% confidence interval 1.1–1.6). When treatment intensity and Regions competed, Regions were no longer independent, suggesting that Regional survival differences are due to therapeutic differences. Furthermore, we found that the age‐adjusted International Prognostic Index was independently associated with survival. We conclude that patients aged ≥80 years with DLBCL appear to benefit from rituximab‐anthracycline‐based treatment given with curative intent.</jats:p>