title: Outcome of frail elderly patients with diffuse large B-cell lymphoma prospectively identified by Comprehensive Geriatric Assessment: results from a study of the Fondazione Italiana Linfomi.
abstract: In 2003 the Fondazione Italiana Linfomi (FIL) started a clinical research program for investigating initial treatment of frail elderly patients with diffuse large B-cell lymphoma (DLBCL) identified by Comprehensive Geriatric Assessment (CGA). From 2003 to 2006, 334 elderly patients underwent CGA assessment, and 99 patients were classified as frail. Frail patients had a median age of 78 years, stage III-IV disease in 62% and age-adjusted International Prognostic Index (aaIPI) of 2-3 in 53%. Treatment consisted of several different regimens according to physician discretion. After a median follow-up of 36 months, 5-year overall survival (OS) was 28%. In multivariate analysis, aaIPI 2-3 (p = 0.005) and the presence of respiratory comorbidity (p = 0.044) were the only factors that showed independent correlation with OS. Frail patients had a poorer outcome compared with fit patients also if they were treated with rituximab-containing combination chemotherapy (hazard ratio 2.37, 95% confidence interval 1.48-3.78; p < 0.001). CGA is a valid tool to prospectively identify frail subjects among elderly patients with DLBCL.
authors.affiliation: Hematology Unit, Arcispedale Santa Maria Nuova, Istituto di Ricovero e Cura a Carattere Scientifico , Reggio Emilia , Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Merli
authors.forename: Stefano
authors.initials: S
authors.lastname: Luminari
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Rossi
authors.forename: Caterina
authors.initials: C
authors.lastname: Mammi
authors.forename: Luigi
authors.initials: L
authors.lastname: Marcheselli
authors.forename: Angela
authors.initials: A
authors.lastname: Ferrari
authors.forename: Michele
authors.initials: M
authors.lastname: Spina
authors.forename: Alessandra
authors.initials: A
authors.lastname: Tucci
authors.forename: Caterina
authors.initials: C
authors.lastname: Stelitano
authors.forename: Isabella
authors.initials: I
authors.lastname: Capodanno
authors.forename: Alberto
authors.initials: A
authors.lastname: Fragasso
authors.forename: Luca
authors.initials: L
authors.lastname: Baldini
authors.forename: Chiara
authors.initials: C
authors.lastname: Bottelli
authors.forename: Elisa
authors.initials: E
authors.lastname: Montechiarello
authors.forename: Stefano
authors.initials: S
authors.lastname: Fogazzi
authors.forename: Cinzia
authors.initials: C
authors.lastname: Lamorgese
authors.forename: Lara
authors.initials: L
authors.lastname: Cavalli
authors.forename: Massimo
authors.initials: M
authors.lastname: Federico
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003131:Combined Modality Therapy; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D016330:Frail Elderly; D015577:Geriatric Assessment; D006801:Humans; D007558:Italy; D016403:Lymphoma, Large B-Cell, Diffuse / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D008297:Male; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D016896:Treatment Outcome