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1000 Titel
  • Age-dependent increase of treatment-related mortality in older patients with aggressive B cell lymphoma: analysis of outcome, treatment feasibility, and toxicity in 1171 elderly patients with aggressive B cell lymphoma—data from phase II and III trials of the DSHNHL (German High-Grade Non-Hodgkin’s Lymphoma Study Group)
1000 Autor/in
  1. Zettl, Florian |
  2. Ziepert, Marita |
  3. Altmann, Bettina |
  4. Zeynalova, Samira |
  5. Held, Gerhard |
  6. Pöschel, Viola |
  7. Hohloch, Karin |
  8. Wulf, Gerald G. |
  9. Glass, Bertram |
  10. Schmitz, Norbert |
  11. Loeffler, Markus |
  12. Trümper, Lorenz |
1000 Erscheinungsjahr 2020
1000 Publikationstyp
  1. Artikel |
1000 Online veröffentlicht
  • 2020-11-26
1000 Erschienen in
1000 Quellenangabe
  • 100(4):1031-1038
1000 Copyrightjahr
  • 2020
1000 Lizenz
1000 Verlagsversion
  • https://doi.org/10.1007/s00277-020-04345-3 |
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7960591/ |
1000 Publikationsstatus
1000 Sprache der Publikation
1000 Abstract/Summary
  • In elderly patients (pts) with aggressive B cell lymphoma (aNHL), curative treatment often cannot be administered because of comorbidities and tolerability. We analyzed the influence of age in pts > 60 years receiving the R-CHOP-14 regimen within different prospective DSHNHL trials. Of the RICOVER-60 trial and CHOP-R-ESC trials, 1171 aNHL pts were included in this retrospective analysis of age-dependent event-free survival (EFS), progression-free survival (PFS), and overall survival (OS). All patients received prophylactic G-CSF, and anti-infective prophylaxis with amphotericin B mouth wash and oral fluorchinolone was optional. In the CHOP-R-ESC trials, prophylaxis was augmented to include mandatory continuous orally administered aciclovir and a pneumocystis prophylaxis with cotrimoxazole as well as oral fluorchinolones during neutropenia. The patient population was separated into 4 age groups (61-65 years, 66-70 years, 71-75 years, and 76-80 years). The results from the RICOVER-60 trial were subsequently confirmed in the following CHOP-R-ESC trials by a multivariate analysis adjusted for IPI factors and gender. Significant differences (p < 0.001) in EFS, PFS, and OS were seen between age groups (RICOVER-60). Hematotoxicity, infections, and TRM increased with age. TRM was significantly elevated in the age group 76-80 years. Therefore, this analysis shows that an age above 75 years defines an especially vulnerable patient population when being treated with chemoimmunotherapy for aNHL. Prophylactic anti-infective drugs are essential and clinically effective in reducing morbidity when treating elderly aNHL pts.
1000 Sacherschließung
lokal Age Factors [MeSH]
lokal Aged, 80 and over [MeSH]
lokal Lymphoma, B-Cell/drug therapy [MeSH]
lokal Aged [MeSH]
lokal Aggressive lymphoma
lokal Prednisone/adverse effects [MeSH]
lokal Multicenter Studies as Topic/statistics
lokal Progression-Free Survival [MeSH]
lokal Clinical Trials, Phase II as Topic/statistics
lokal Cyclophosphamide/adverse effects [MeSH]
lokal Diffuse large cell lymphoma
lokal Feasibility Studies [MeSH]
lokal Rituximab/administration
lokal Cyclophosphamide/administration
lokal Original Article
lokal Clinical Trials, Phase III as Topic/statistics
lokal Male [MeSH]
lokal Rituximab/adverse effects [MeSH]
lokal Doxorubicin/administration
lokal Randomized Controlled Trials as Topic/statistics
lokal Elderly patients
lokal Vincristine/administration
lokal Dose-Response Relationship, Drug [MeSH]
lokal Antibiotic Prophylaxis [MeSH]
lokal Female [MeSH]
lokal Doxorubicin/adverse effects [MeSH]
lokal Infections
lokal Kaplan-Meier Estimate [MeSH]
lokal Humans [MeSH]
lokal Treatment Outcome [MeSH]
lokal Retrospective Studies [MeSH]
lokal Middle Aged [MeSH]
lokal Lymphoma, B-Cell/mortality [MeSH]
lokal Treatment-related mortality
lokal Antineoplastic Combined Chemotherapy Protocols/administration
lokal Antineoplastic Combined Chemotherapy Protocols/therapeutic use [MeSH]
lokal Prednisone/administration
lokal Antineoplastic Combined Chemotherapy Protocols/adverse effects [MeSH]
lokal Vincristine/adverse effects [MeSH]
1000 Liste der Beteiligten
  1. https://frl.publisso.de/adhoc/uri/WmV0dGwsIEZsb3JpYW4=|https://frl.publisso.de/adhoc/uri/WmllcGVydCwgTWFyaXRh|https://frl.publisso.de/adhoc/uri/QWx0bWFubiwgQmV0dGluYQ==|https://frl.publisso.de/adhoc/uri/WmV5bmFsb3ZhLCBTYW1pcmE=|https://frl.publisso.de/adhoc/uri/SGVsZCwgR2VyaGFyZA==|https://frl.publisso.de/adhoc/uri/UMO2c2NoZWwsIFZpb2xh|https://frl.publisso.de/adhoc/uri/SG9obG9jaCwgS2FyaW4=|https://frl.publisso.de/adhoc/uri/V3VsZiwgR2VyYWxkIEcu|https://frl.publisso.de/adhoc/uri/R2xhc3MsIEJlcnRyYW0=|https://frl.publisso.de/adhoc/uri/U2NobWl0eiwgTm9yYmVydA==|https://frl.publisso.de/adhoc/uri/TG9lZmZsZXIsIE1hcmt1cw==|https://frl.publisso.de/adhoc/uri/VHLDvG1wZXIsIExvcmVueg==
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