Treatment outcomes of diffuse large B cell lymphoma in elderly patients based on a seven-year experience in Chung Shan Medical University Hospital

Background: To assess the clinical outcomes of elderly patients aged ＞ 65 years diagnosed with diffuse large B cell lymphoma (DLBCL). Materials and Methods: This is a single-institute, retrospective, cohort study. A total of 44 elderly DLBCL patients were enrolled from Jan 2011 to Dec 2017. Clinical characteristics were retrospectively reviewed based on medical records. Cox proportional hazards model was applied to univariate and multivariate analyses. Survival was estimated using Kaplan-Meier method and log-rank test. Results: A total of 44 elderly DLBCL patients were enrolled in our study. Most presented with poor performance status (ECOG ＞ 1, 68.6%, 24/35) and advanced stage (Ann Arbor staging ＞ II, 65.1%, 28/43). Median follow-up time and overall survival (OS) were 11.2 and 13.8 months, respectively. Patients with standard-dose treatment showed better OS than those with reduced-dose treatment (median OS, 28.0 vs. 14.2 months, P = 0.135). On univariate analysis, performance status (P = 0.023), Ann Arbor staging (P = 0.018), extranodal involvement (P = 0.019), and elevated LDH (P = 0.008) were significant factors for OS. However, only elevated LDH was an independent factor (hazard ratio [HR], 95% confidence index [CI], 3.239 (1.152-9.110), P = 0.026). Performance status (ECOG ＞ 1, HR [95% CI], 4.711[0.991-22.396], P = 0.051) was an independent factor on multivariate analysis. Conclusion: Standard-dose chemoregimens are suggested for elderly DLBCL patients. Elevated LDH and performance status are independent factors in clinical practice.