Factors associated with achieving complete response in patients older than 65 years diagnosed with diffuse large b-cell lymphoma in first-line therapy. report from a tertiary center in Mexico city

Abstract

Abstract Introduction: The prevalence of diffuse large B-cell lymphoma (DLBCL) in the geriatric population has increased in recent decades. The primary objectives in this population are to achieve complete response in first-line therapy (CR1), improve quality of life, and overall survival (OS) with minimal adverse effects.Objective: To identify the variables that helped patients achieve complete response in conjunction with the chemotherapy regimen.Methodology: Retrospective, observational, and descriptive study. Patients over 65 years with a diagnosis (Dx) of DLBCL treated at the National Cancer Institute from January 2018 to December 2023 were included. Sociodemographic characteristics were collected, potential associated factors (clinical, biochemical, and social) and clinical outcome were recorded, with achievement of CR1 and OS using Cox regression.Results: A total of 253 patients were identified, with a predominance of women (58%), age of 73 years (range, 65–94 years), and approximately 70% with an adverse prognosis (RIPI). The most commonly used treatment was R-CHOP (59%), followed by R-miniCHOP (17%). Complete response was 53%, and the median overall survival was 72 months (range, 62–82 months). Factors associated with a higher CR1 rate were: having a support network (OR=2.603, p=0.017), admission to the Intensive Care Unit (ICU) (OR=3.583, p=0.008), and normal leukocyte count at diagnosis (OR=1.011, p=0.041). Factors that improved OS were: support from palliative care services (HR=4.73, p=0.01) and ICU (HR=13.95, p=0.001), CR1 (HR=1.890, p=0.001), dose (HR=2.159, p=0.08), and consolidation radiotherapy (HR=4.77, p=0.027).Conclusions: It is important to identify factors associated with improved CR1 and OS in this age group. However, the information obtained through prospective studies needs to be confirmed and strengthened.