Charlson Comorbidity Index is an independent prognostic factor among elderly patients with diffuse large B-cell lymphoma

Kobayashi, Yohnosuke; Miura, Katsuhiro; Hojo, Atsuko; Hatta, Yoshihiro; Tanaka, Torahiko; Kurita, Daisuke; Iriyama, Noriyoshi; Kobayashi, Shogo; Jin, Tao

doi:10.1007/s00432-010-0973-x

Cited by 64 publications

(52 citation statements)

References 17 publications

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“…In a recent study, male sex, poor MNA, advanced disease stage, and poor mobility were found to be the 4 independent factors associated with early death (31) In this study, 44% of the patients received a full-dose regimen, 14% received reduced chemotherapy, and 42% received the best supportive care. A recent retrospective analysis conducted in elderly patients with DLBCL showed that high scores in the Charlson Comorbidity Index were an independent factor associated with low dose-intensity regimen and worse outcome, whereas age exceeding 80 years was not (78). So, while the best method for identifying nonfit patients is not known, it is important to use one of the available indices before treatment, and to include them in clinical trials in which patients more than 65 years of age are enrolled.…”

Section: Resultsmentioning

confidence: 99%

Diffuse Large B-cell Lymphoma in the Elderly: A Review of Potential Difficulties

Sarkozy

2013

Clinical Cancer Research

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Half of patients with diffuse large B-cell lymphoma (DLBCL) are more than 65 years old. These elderly patients frequently have other diseases, some of them severe, which may alter their ability to receive standard curative therapy. However, these associated diseases are heterogeneous and only a few contraindicate chemotherapy treatments. We reviewed all potential difficulties, such as the evaluation of comorbidities, the heterogeneous functional status of this population, and the consequences of the aging process that might be associated with treating these patients, and now propose solutions. As standard rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) chemotherapy may cure the majority of patients, it must always be the first proposed option. With this approach, elderly patients with DLBCL treated with a curative intent can reach a complete remission and have a similar outcome as younger patients. Reduced dose intensity must be applied for very elderly patients or those unfit for full-dose anthracycline. The critical question for a physician is why these patients cannot be treated with the standard regimen, namely R-CHOP.

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Section: Resultsmentioning

confidence: 99%

Diffuse Large B-cell Lymphoma in the Elderly: A Review of Potential Difficulties

Sarkozy

2013

Clinical Cancer Research

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“…We previously reported that older patients with DLBCL may be treated with standard R-CHOP, the same as younger patients if their comorbid condition is tolerable (26). Recently, the entity of the RDI was proposed as an index of the intensity of chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

Long-term follow-up of localized, primary gastric diffuse large B-cell lymphoma treated with rituximab and CHOP

Kobayashi

Hatta

Hojo

et al. 2011

Experimental and Therapeutic Medicine

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Abstract. The addition of rituximab to cyclophosphamide, doxorubicin, vincristine and prednisone [CHOP (i.e., R-CHOP)] is considered to be the standard regimen for treating localized, primary gastric diffuse large B-cell lymphoma (PG-DLBCL). However, few studies have reported the long-term efficacy of R-CHOP therapy in the management of localized PG-DLBCL. In the present study, we performed a retrospective analysis of 11 patients with localized PG-DLBCL, who were treated with R-CHOP at Nihon University Itabashi Hospital and Kasukabe Municipal Hospital (Japan) from 2001 to 2008. Limited stage cancer was defined as stage I/II according to the Lugano staging system for gastrointestinal (GI) lymphomas. The relative dose intensity (RDI) of CHOP therapy was calculated for each patient. The median age of the patients was 68 years (range, 48-82). Gastralgia and anemia were common symptoms at initial presentation. All patients except 1 received 6 cycles of R-CHOP treatment without consolidative radiation therapy or prior surgery. RDI was maintained at over 80% in 9 out of 11 patients. All patients achieved complete remission and the estimated overall survival with a median follow-up of 54 months (range, 39-103) was 100%, without relapse or significant GI adverse effects, such as perforation or bleeding during R-CHOP treatment. No long-term adverse effects of rituximab were recorded during the observation period. Helicobacter pylori infection was diagnosed in 72.7% (8 cases) of the patients, but was eradicated in a limited number of patients. Our data suggest the feasibility and effectiveness of the addition of rituximab to conventional CHOP therapy in the management of localized PG-DLBCL.

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“…1 The depth of hematologic response, in particular the achievement of complete hematologic response (CR), has been shown to be predictive of clinical response, quality of life and improvement in survival.…”

Section: Bortezomib and High-dose Melphalan Conditioning For Stem Celmentioning

confidence: 99%

The proportion of activated B-cell like subtype among de novo diffuse large B-cell lymphoma increases with age

Mareschal¹,

Lanic²,

Ruminy³

et al. 2011

Haematologica

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Charlson Comorbidity Index is an independent prognostic factor among elderly patients with diffuse large B-cell lymphoma

Abstract: Among elderly DLBCL, high CCI was independently associated with worse outcome. Novel discrete strategies for these deteriorated patients are therefore warranted.

Cited by 64 publications

References 17 publications

Diffuse Large B-cell Lymphoma in the Elderly: A Review of Potential Difficulties

Diffuse Large B-cell Lymphoma in the Elderly: A Review of Potential Difficulties

Long-term follow-up of localized, primary gastric diffuse large B-cell lymphoma treated with rituximab and CHOP

The proportion of activated B-cell like subtype among de novo diffuse large B-cell lymphoma increases with age

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