A Prognostic Score for Survival in Patients Older than 65 Years with Diffuse Large B-Cell Lymphoma

Myrna Candelaria-Hernández, Research Division, Instituto Nacional de Cancerología (INCan), Mexico City
Nancy Reynoso-Noverón, Epidemiology Unit, Instituto Nacional de Cancerología, SSA, Mexico City, Mexico
Mayra Ponce, Clinical Research Division, Instituto Nacional de Cancerología, Mexico City, Mexico
Rodrigo Castillo-Llanos, Clinical Research Division, Instituto Nacional de Cancerología, Mexico City, Mexico
Diana Nolasco-Medina, Department of Hematology, Instituto Nacional de Cancerología, Mexico City, Mexico
David Cantú-de-León, Research Division, Instituto Nacional de Cancerología (INCan), Mexico City, Mexico

Background: Available prognosis scores for patients with diffuse large B-cell lymphoma (DLBCL) included a limited number of patients ≥ 65 years of age, and most of them did not include comorbidities. Here, we propose a prognostic score for overall survival (OS) for this group of patients. Materials and Methods: Patients ≥ 65 years with DLBCL treated at a single national reference center were included. Clinical features including comorbidities and biochemical parameters were analyzed. Results: We included 141 patients. Response rate in the whole group was 77%. Based on multivariate analysis, the presence of the European Cooperative Oncology Group (ECOG) > 2, elevated levels of beta-2 microglobulin, bulky disease, and anemia (hemoglobin < 10 g/dL) had a significant effect on OS. These parameters were considered when computing the prognostic score, which identified three groups with differential survival: Low, intermediate, and high risk of death, with a probability of survival at 60 months of 80.05%, 55.5%, and 29.84%, respectively. Discussion: This score may select patients to optimize treatment. The presence of high levels of beta-2 microglobulin, bulky disease, and hemoglobin < 10 g/dL, and ECOG > 2 was associated with poor OS in elderly patients with DLBCL.

Keywords: Diffuse large B-cell lymphoma. Prognostic score. Survival and lymphoma. Elderly and survival. Rituximab and prognosis.