Clinical characteristics, treatment patterns, and outcomes of patients aged ≥ 80 years with aggressive lymphomas: A real-world single-center experience.

Abstract

e13772 Background: Population aging has led to a growing number of patients aged ≥80 years diagnosed with lymphoma. However, this clinically heterogeneous group remains underrepresented in real-world data on aggressive lymphomas, particularly in Latin America. Methods: We conducted a retrospective observational cohort study of patients aged ≥80 years at diagnosis with aggressive lymphomas treated at Fundación Santa Fe de Bogotá between 2015 and 2025. Overall survival (OS) and progression-free survival (PFS) were estimated using the Kaplan–Meier method. Results: A total of 33 patients aged ≥80 years were included. Mean age was 87 years (SD 3.8), and 54.5% were female. Functional status was largely preserved: 81.8% had an ECOG performance status of 0–1, and 85.2% were functionally independent; frailty was identified in 14.8% based on geriatric assessment. Diffuse large B-cell lymphoma (DLBCL) was the most frequent histology (60.6%), followed by transformed follicular lymphoma and grade 3B disease (18.2%). Advanced disease was common, with 37.5% presenting with Ann Arbor stage IV and 73.9% having an International Prognostic Index (IPI) ≥3. Systemic therapy was administered to 93.9% of patients, most commonly anti-CD20–based regimens (90.6%). First-line treatment consisted primarily of R-CHOP (41.9%) or R-mini-CHOP (29%). Overall, 79.3% received standard-intensity therapy and 20.7% attenuated-intensity regimens. First-line therapy was completed in 84% of patients. Dose reductions occurred in four patients. Nearly half of patients (45.5%) experienced no adverse events. Second-line therapy was administered in eight patients (25.8%), most commonly anti-CD20–based regimens (75%). Chronological age, functional dependence, frailty, and ECOG performance status were not associated with treatment receipt, treatment intensity, or discontinuation. After a median follow-up of 61.3 months, median OS and PFS were not reached, with no significant differences observed according to treatment intensity or ECOG status. Conclusions: Among patients aged ≥80 years with aggressive lymphomas, preserved functional status and low frailty were common. Systemic therapy, including standard-intensity regimens, was feasible and well tolerated in selected patients regardless of chronological age. These findings support treatment decisions guided by biological and functional assessment rather than age alone in octogenarian patients with aggressive lymphoma. Baseline clinical and geriatric characteristics of patients aged ≥80 years with aggressive lymphomas. Characteristics DLBCL (n=17) tFL (n=6) Frailty, n (%) 3 (17.6%) 0 (0%) Functionally independent 13 (92.8%) 5 (83.3%) Ann Arbor stage III 6 (31.58%) 3 (50%) Ann Arbor stage IV 6 (31.58%) 2 (33.3%) R-CHOP 9 (47.3%) 2 (40%) R-mini-CHOP 5 (26.3%) 1 (20%)