Determination of the appropriate chemotherapy for patients aged 80 years or older with diffuse large B cell lymphoma

Determination of the appropriate chemotherapy for patients aged 80 years or older with diffuse large B cell lymphoma | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Determination of the appropriate chemotherapy for patients aged 80 years or older with diffuse large B cell lymphoma Min Jung Kim, Junhun Cho, Won Seog Kim, Seok Jin Kim, Sang Eun Yoon This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4463312/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract The optimal chemotherapy for newly diagnosed (ND) diffuse large B-cell lymphoma (DLBCL) in patients aged 80 years or older has not been conclusively determined. Due to the expected toxicities and comorbidities in this age group, intensifying the dosages of chemotherapy may not always be a viable solution. However, undertreating the disease based solely on a patient’s frailties can lead to disease progression, and patients often succumb to the disease in routine practices. This retrospective study was conducted to determine whether there is an optimal regimen for elderly DLBCL patients. We selected ND-DLBCL patients aged 80 years or older and excluded those who did not receive chemotherapies or those who received treatment other than combinations of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) or rituximab and bendamustine (BR). We assessed the efficacies, survival outcomes, and toxicity according to the regimen, including standard-dose R-CHOP, R-miniCHOP, and BR. The patients who received the standard dose of R-CHOP presented a better overall response rate (ORR) than those who received R-miniCHOP. Moreover, there was no significant difference in progression-free survival (PFS, p = 0.581) or overall survival (OS, p = 0.693) among the patients who received standard-dose R-CHOP, R-miniCHOP, or BR. The patients with Eastern Cooperative Oncology Group performance status of 0–1, serum albumin ≥ 3.5 g/dL, early stage, and GCB subtype were associated with superior PFS and OS. The incidence of any grade or grade ≥ 3 neutropenia was reported in patients who received the standard dose of R-CHOP, but there were no significant differences in treatment-related mortality across the regimens. Nevertheless, the patients who addressed adverse events and followed the planned treatment schedules seemed to achieve better treatment survival outcomes. No single superior regimen was found for DLBCL patients ≥80 years. These insights provide valuable guidance for tailoring treatment strategies to optimize outcomes for elderly DLBCL patients, particularly those with poor health conditions and specific phenotypic characteristics. Thus, comprehensive evaluation before chemotherapy initiation needs to be performed for better survival outcomes. diffuse large B-cell lymphoma elderly patient anthracycline-containing regimen Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4463312","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":311993179,"identity":"e8ad4e50-07cd-4d3c-b698-2d55eb3fff59","order_by":0,"name":"Min Jung Kim","email":"","orcid":"","institution":"Soonchunhyang University Bucheon Hospital","correspondingAuthor":false,"prefix":"","firstName":"Min","middleName":"Jung","lastName":"Kim","suffix":""},{"id":311993181,"identity":"26c54c9f-87c7-4799-b56e-939822aa2cc4","order_by":1,"name":"Junhun Cho","email":"","orcid":"","institution":"Samsung Medical Center, Sungkyunkwan University School of Medicine","correspondingAuthor":false,"prefix":"","firstName":"Junhun","middleName":"","lastName":"Cho","suffix":""},{"id":311993182,"identity":"cef38f2b-edec-4d86-8c5e-0a6a2498a869","order_by":2,"name":"Won Seog Kim","email":"","orcid":"","institution":"Samsung Medical Center, Sungkyunkwan University School of Medicine","correspondingAuthor":false,"prefix":"","firstName":"Won","middleName":"Seog","lastName":"Kim","suffix":""},{"id":311993183,"identity":"7dba3aa1-0c33-4b2c-a009-83c4019634c2","order_by":3,"name":"Seok Jin Kim","email":"","orcid":"","institution":"Samsung Medical Center, Sungkyunkwan University School of Medicine","correspondingAuthor":false,"prefix":"","firstName":"Seok","middleName":"Jin","lastName":"Kim","suffix":""},{"id":311993184,"identity":"249c6ba5-240e-4498-8247-6529061f9f6f","order_by":4,"name":"Sang Eun Yoon","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA/ElEQVRIiWNgGAWjYLCCBwwMjG38zQcffABy2NgJKWcD4gSgln6JY8mGM0ACzMRqmdmQYybMAxIhpEV+fvOzDwkVdrIbDhwwY7b5tU2ej5mB8cPHHNxaDI6xGc9IOJNsvOFwQ9rj3L7bhm3MDMySM7fh0cLGYMyQ2MacCLTluHFuz21GoBY2Zl48WuTb2D8DtdQDtSS2SVv23LYnqIXhGA/IlsOJMxuS2aQZftxOJKjF4FhOMUPCmePGwEBmNuxtuJ3cxszYjNcv8s3HNzN8qKiWbePv//jgx5/btvPbmw9++IjPYSiAsQ1MNhCrHgT+kKJ4FIyCUTAKRgoAAONRVIoDSX7wAAAAAElFTkSuQmCC","orcid":"","institution":"Samsung Medical Center, Sungkyunkwan University School of Medicine","correspondingAuthor":true,"prefix":"","firstName":"Sang","middleName":"Eun","lastName":"Yoon","suffix":""}],"badges":[],"createdAt":"2024-05-22 23:53:14","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4463312/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4463312/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":66326916,"identity":"592ab7b8-d06b-4a09-885b-7a314afedc3f","added_by":"auto","created_at":"2024-10-10 13:02:05","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1424129,"visible":true,"origin":"","legend":"","description":"","filename":"2.Maintextwithfigures.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4463312/v1_covered_eb04fc3b-c9af-4447-b6c5-84ab301be4d2.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Determination of the appropriate chemotherapy for patients aged 80 years or older with diffuse large B cell lymphoma","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"diffuse large B-cell lymphoma, elderly patient, anthracycline-containing regimen","lastPublishedDoi":"10.21203/rs.3.rs-4463312/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4463312/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eThe optimal chemotherapy for newly diagnosed (ND) diffuse large B-cell lymphoma (DLBCL) in patients aged 80 years or older has not been conclusively determined. Due to the expected toxicities and comorbidities in this age group, intensifying the dosages of chemotherapy may not always be a viable solution. However, undertreating the disease based solely on a patient\u0026rsquo;s frailties can lead to disease progression, and patients often succumb to the disease in routine practices. This retrospective study was conducted to determine whether there is an optimal regimen for elderly DLBCL patients. We selected ND-DLBCL patients aged 80 years or older and excluded those who did not receive chemotherapies or those who received treatment other than combinations of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) or rituximab and bendamustine (BR). We assessed the efficacies, survival outcomes, and toxicity according to the regimen, including standard-dose R-CHOP, R-miniCHOP, and BR. The patients who received the standard dose of R-CHOP presented a better overall response rate (ORR) than those who received R-miniCHOP. Moreover, there was no significant difference in progression-free survival (PFS, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.581) or overall survival (OS, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;=\u0026thinsp;0.693) among the patients who received standard-dose R-CHOP, R-miniCHOP, or BR. The patients with Eastern Cooperative Oncology Group performance status of 0\u0026ndash;1, serum albumin\u0026thinsp;\u0026ge;\u0026thinsp;3.5 g/dL, early stage, and GCB subtype were associated with superior PFS and OS. The incidence of any grade or grade\u0026thinsp;\u0026ge;\u0026thinsp;3 neutropenia was reported in patients who received the standard dose of R-CHOP, but there were no significant differences in treatment-related mortality across the regimens. Nevertheless, the patients who addressed adverse events and followed the planned treatment schedules seemed to achieve better treatment survival outcomes. No single superior regimen was found for DLBCL patients \u0026ge;80 years. These insights provide valuable guidance for tailoring treatment strategies to optimize outcomes for elderly DLBCL patients, particularly those with poor health conditions and specific phenotypic characteristics. Thus, comprehensive evaluation before chemotherapy initiation needs to be performed for better survival outcomes.\u003c/p\u003e","manuscriptTitle":"Determination of the appropriate chemotherapy for patients aged 80 years or older with diffuse large B cell lymphoma","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-06-12 12:08:57","doi":"10.21203/rs.3.rs-4463312/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"048c0d6b-b82f-48bb-90ec-6fcb3c2a9603","owner":[],"postedDate":"June 12th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-10-10T12:53:56+00:00","versionOfRecord":[],"versionCreatedAt":"2024-06-12 12:08:57","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4463312","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4463312","identity":"rs-4463312","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}