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Survival of very elderly patients with diffuse large B‐cell lymphoma according to treatment intensity in the immunochemotherapy era: a Swedish Lymphoma Register study
- Source :
- British Journal of Haematology. 192:75-81
- Publication Year :
- 2020
- Publisher :
- Wiley, 2020.
-
Abstract
- 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.
- Subjects :
- Male
medicine.medical_specialty
Population
03 medical and health sciences
Antineoplastic Agents, Immunological
0302 clinical medicine
International Prognostic Index
Internal medicine
medicine
Humans
education
Adverse effect
Aged, 80 and over
Sweden
education.field_of_study
business.industry
Incidence (epidemiology)
Hazard ratio
Age Factors
Hematology
medicine.disease
Survival Analysis
Comorbidity
Confidence interval
030220 oncology & carcinogenesis
Female
Immunotherapy
Lymphoma, Large B-Cell, Diffuse
Rituximab
business
Diffuse large B-cell lymphoma
Follow-Up Studies
030215 immunology
Subjects
Details
- ISSN :
- 13652141 and 00071048
- Volume :
- 192
- Database :
- OpenAIRE
- Journal :
- British Journal of Haematology
- Accession number :
- edsair.doi.dedup.....bd12fa3a6e94ab8c0cf3f13170968bda