A comprehensive approach to therapy of haematological malignancies in older patients

Eyre, Toby A.; Klepin, Heidi D.; Wildes, Tanya M.; Goede, Valentin

doi:10.1016/s2352-3026(21)00241-6

Cited by 23 publications

(17 citation statements)

References 76 publications

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“…A careful use of supportive care is another important way to improve outcome and quality of life in this group of patients. 16,19,20 Although the reported results come from a large number of octogenarians consecutively treated in specialized centers, this study has some limitations. Patients in very compromised clinical conditions or with very advanced disease may be lost as they are often not referred to secondlevel centers.…”

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confidence: 96%

Diffuse large B-cell lymphoma in octogenarians aged 85 and older can benefit from treatment with curative intent: a report on 129 patients prospectively registered in the Elderly Project of the Fondazione Italiana Linfomi (FIL)

et al. 2022

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Octogenarian patients with diffuse large B-cell lymphoma are managed mainly with palliation, but recent improvement in their overall condition makes potentially curative treatment a possibility. Studies have shown that half of selected octogenarians may be cured using reduced-dose anthracycline chemoimmunotherapy. However, patients aged >85 (late octogenarians–LO) were underrepresented, and selection criteria were poorly defined. We analyzed the clinical characteristics and outcomes of LO enrolled in the FIL Elderly Project (EP) in terms of the treatment received (palliative vs curative) and of their simplified geriatric assessment (sGA), then compared them with early octogenarians (EO) aged 80-84 and with those aged 65-79 classified as UNFIT or FRAIL according to sGA enrolled in the same study. Of the 1163 patients, 370 were >80 and 129 LO. Clinical characteristics were similar between LO and EO, but LO more frequently received palliation (50% vs 23%: P=0.001) and had worse 2-year overall survival (OS) (48% vs 63%: P=0.001) and 2-year progression-free survival (PFS) (43% vs 56%: P=0.01). Patients receiving anthracycline did better than patients receiving palliation (P

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confidence: 96%

Diffuse large B-cell lymphoma in octogenarians aged 85 and older can benefit from treatment with curative intent: a report on 129 patients prospectively registered in the Elderly Project of the Fondazione Italiana Linfomi (FIL)

et al. 2022

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“…In line with our and other prior analyses, R-MCI subgroups differed exceedingly more than age or dose intensitysubgroups, supporting the paradigm of an objective, functional GA and risk score. 5,8,[39][40][41][42] Notably, ≥70 years and 60-69-year old (transplant eligible) patients showed similar results regarding SAEs, OS and PFS and thereby differed to <60-year old patients, whereas for fitness groups, fit-and intermediate patients were comparable and much distinct to frail patients. Since patients ≥70 years are often excluded from clinical trials and more intensive therapies, we assessed this age group more thoroughly.…”

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confidence: 91%

An objective assessment in newly diagnosed multiple myeloma to avoid treatment complications and strengthen therapy adherence

et al. 2022

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In heterogeneous multiple myeloma (MM) patients treatment decisions are challenging. The hypothesis was that adaptation of treatment intensity (dose reduction [DR] vs. none) according to an objective risk score (Revised-Myeloma Comorbidity Index [R-MCI]) rather than physician judgement alone may improve therapy efficacy and avoid toxicities. We performed this study in 250 consecutive MM patients who underwent a prospective fitness assessment at our center, yet received induction protocols based on physicians’ judgement. DR, serious adverse events (SAEs), response, progression free- (PFS) and overall survival (OS) were compared in fitness (fit, intermediate-fit, frail), age (

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“…Overall, survival rates differed considerably across agegroups, a well-established prognostic factor for most cancers (30). The poor survival of elderly patients with LN is mainly attributed to the presence of comorbidities or to their frail status, which hampers firstly, seeking for a specific diagnosis, and subsequently, the application of several treatment protocols, such as several chemotherapy regimens or stem-cell transplantation (31)(32)(33). On the other hand, we evidenced differences in the survival of mature B, T and NK-cell neoplasms between sexes that would be related to the impact of chromosomal and hormonal control of immunity (34), among other factors, and its consequent cancer evolution and response to treatment (35,36).…”

Section: Discussionmentioning

confidence: 99%

Incidence and survival of lymphoid neoplasms in Spain, 2002-2013: A population-based study from the Spanish Network of Cancer Registries (REDECAN)

Pla

Solans²,

Ameijide³

et al. 2022

Front. Oncol.

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IntroductionThe aim of this study was to describe incidence, incidence trends and survival patterns of lymphoid neoplasms (LNs) and its subtypes in Spain in the period 2002-2013 using data from the Spanish Network of Cancer Registries (REDECAN).Materials and MethodsData were extracted from 13 Spanish population-based cancer registries. LNs incident cases were codified using the International Classification of Diseases for Oncology, third edition (ICD-O-3) and grouped according to the WHO 2008 classification. Age-standardized incidence rates to the 2013 European standard population (ASIRe) were obtained. Poisson regression models were used to analyze trends in incidence rates and estimate the annual percentage change (APC) for each subtype. The number of cases in Spain for 2023 was estimated by applying the estimated age-specific rates for the year 2023 to the 2023 Spanish population. Observed survival (OS) was estimated by the Kaplan-Meier method and net survival (NS) by the Pohar-Perme method. Sex- and age-specific estimates of 5-year NS were calculated, as well as its changes according to two periods of diagnosis (2002-2007 and 2008-2013).ResultsLNs accounted for 69% (n=39,156) of all hematological malignancies (n=56,751) diagnosed during the period of study. Median age at diagnosis was 67 years (interquartile range (IQR) = 52-77). The overall ASIRe was 34.23 (95% confidence interval (CI): 33.89, 34.57) and showed a marked male predominance in almost all subtypes (global sex ratio = 1.45). During the study period, incidence trends of LNs remained stable (APC: 0.3; 95% CI: -0.1, 0.6), nevertheless some subtypes showed statistically significant variations, such as LNs NOS category (APC: -5.6; 95% CI: -6.8, -4.3). Around 17,926 new cases of LNs will be diagnosed in 2023 in Spain. Survival rates differed considerably across age-groups, while they were similar between men and women. Five- year NS was 62.81% (95% CI: 62.1, 63.52) for all LNs, and varied widely across LNs subtypes, ranging from 39.21% to 90.25%. NS for all LNs improved from the first period of diagnosis to the second one, being 61.57% (95% CI: 60.56, 62.61) in 2002-2007 and 64.17% (95% CI: 63.29, 65.07) in 2008-2013.ConclusionsThis study presents the first complete and extensive population-based analysis of LNs incidence and survival in Spain. These population-based data provide relevant information to better understand the epidemiology of LNs in Southern Europe and it features some useful points for public health authorities and clinicians. However, additional improvements regarding the registration of these hematological neoplasms can be implemented.

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A comprehensive approach to therapy of haematological malignancies in older patients

Cited by 23 publications

References 76 publications

Diffuse large B-cell lymphoma in octogenarians aged 85 and older can benefit from treatment with curative intent: a report on 129 patients prospectively registered in the Elderly Project of the Fondazione Italiana Linfomi (FIL)

Diffuse large B-cell lymphoma in octogenarians aged 85 and older can benefit from treatment with curative intent: a report on 129 patients prospectively registered in the Elderly Project of the Fondazione Italiana Linfomi (FIL)

An objective assessment in newly diagnosed multiple myeloma to avoid treatment complications and strengthen therapy adherence

Incidence and survival of lymphoid neoplasms in Spain, 2002-2013: A population-based study from the Spanish Network of Cancer Registries (REDECAN)

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