A prognostic score for survival in patients older than 65 years with Diffuse Large B-Cell Lymphoma

Rev Invest Clin. 2018;70(1):46-52. doi: 10.24875/RIC.18002450.

Abstract

Background: Available prognosis scores for patients with diffuse large B-cell lymphoma (DLBCL) included a limited number of patients ≥ 65 years of age, and most of them did not include comorbidities. Here, we propose a prognostic score for overall survival (OS) for this group of patients.

Materials and methods: Patients ≥ 65 years with DLBCL treated at a single national reference center were included. Clinical features including comorbidities and biochemical parameters were analyzed.

Results: We included 141 patients. Response rate in the whole group was 77%. Based on multivariate analysis, the presence of the European Cooperative Oncology Group (ECOG) > 2, elevated levels of beta-2 microglobulin, bulky disease, and anemia (hemoglobin < 10 g/dL) had a significant effect on OS. These parameters were considered when computing the prognostic score, which identified three groups with differential survival: Low, intermediate, and high risk of death, with a probability of survival at 60 months of 80.05%, 55.5%, and 29.84%, respectively.

Discussion: This score may select patients to optimize treatment. The presence of high levels of beta-2 microglobulin, bulky disease, and hemoglobin < 10 g/dL, and ECOG > 2 was associated with poor OS in elderly patients with DLBCL.

Keywords: Diffuse large B-cell lymphoma; Elderly and survival; Prognostic score; Rituximab and prognosis; Survival and lymphoma.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anemia / epidemiology*
  • Female
  • Humans
  • Lymphoma, Large B-Cell, Diffuse / drug therapy
  • Lymphoma, Large B-Cell, Diffuse / pathology*
  • Male
  • Multivariate Analysis
  • Prognosis
  • Retrospective Studies
  • Survival Rate
  • beta 2-Microglobulin / metabolism*

Substances

  • beta 2-Microglobulin