title: Comprehensive geriatric assessment is an essential tool to support treatment decisions in elderly patients with diffuse large B-cell lymphoma: a prospective multicenter evaluation in 173 patients by the Lymphoma Italian Foundation (FIL).
abstract: We performed a multicenter study to validate the concept that a simple comprehensive geriatric assessment (CGA) can identify elderly, non-fit patients with diffuse large B-cell lymphoma (DLBCL) in whom curative treatment is not better then palliation, and to analyze potential benefits of treatment modulation after further subdividing the non-fit category by CGA criteria. One hundred and seventy-three patients aged > 69 treated with curative or palliative intent by clinical judgement only were grouped according to CGA into fit (46%), unfit (16%) and frail (38%) categories. Two-year overall survival (OS) was significantly better in fit than in non-fit patients (84% vs. 47%; p < 0.0001). Survival in unfit and frail patients was not significantly different. Curative treatment slightly improved 2-year OS in unfit (75% vs. 45%) but not in frail patients (44% vs. 39%). CGA was confirmed as very efficient in identifying elderly patients with DLBCL who can benefit from a curative approach. Further efforts are needed to better tailor therapies in non-fit patients.
authors.affiliation: Department of Hematology, Spedali Civili , Brescia , Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Tucci
authors.forename: Maurizio
authors.initials: M
authors.lastname: Martelli
authors.forename: Luigi
authors.initials: L
authors.lastname: Rigacci
authors.forename: Paola
authors.initials: P
authors.lastname: Riccomagno
authors.forename: Maria Giuseppina
authors.initials: MG
authors.lastname: Cabras
authors.forename: Flavia
authors.initials: F
authors.lastname: Salvi
authors.forename: Caterina
authors.initials: C
authors.lastname: Stelitano
authors.forename: Alberto
authors.initials: A
authors.lastname: Fabbri
authors.forename: Sergio
authors.initials: S
authors.lastname: Storti
authors.forename: Stefano
authors.initials: S
authors.lastname: Fogazzi
authors.forename: Salvatrice
authors.initials: S
authors.lastname: Mancuso
authors.forename: Maura
authors.initials: M
authors.lastname: Brugiatelli
authors.forename: Angelo
authors.initials: A
authors.lastname: Fama
authors.forename: Paolo
authors.initials: P
authors.lastname: Paesano
authors.forename: Benedetta
authors.initials: B
authors.lastname: Puccini
authors.forename: Chiara
authors.initials: C
authors.lastname: Bottelli
authors.forename: Daniela
authors.initials: D
authors.lastname: Dalceggio
authors.forename: Francesco
authors.initials: F
authors.lastname: Bertagna
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Rossi
authors.forename: Michele
authors.initials: M
authors.lastname: Spina
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D018572:Disease-Free Survival; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis* / Q000628:therapy*; D015999:Multivariate Analysis; D010166:Palliative Care / Q000379:methods*; D011379:Prognosis; D011446:Prospective Studies; D016896:Treatment Outcome
keywords: Lymphoma and Hodgkin disease; chemotherapeutic approaches; immunotherapy