OUTCOMES OF DIFFUSE LARGE B-CELL LYMPHOMA IN OLDER ADULTS TREATED IN RESOURCE-CONSTRAINED SETTINGS
Objective: Treating Diffuse Large B-Cell Lymphoma (DLBCL) in elderly patients is challenging. There is limited data available from Low- and Middle-Income Countries (LMICs) on elderly DLBCL. We analyzed the presentations and survival outcomes of patients with DLBCL according to their socioeconomic st...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-07-01
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| Series: | Hematology, Transfusion and Cell Therapy |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2531137925001610 |
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| author | Natasha Ali Raheel Iftikhar Zeeshan Khan Usman Ahmed Humera Mahmood Zeba Aziz |
| author_facet | Natasha Ali Raheel Iftikhar Zeeshan Khan Usman Ahmed Humera Mahmood Zeba Aziz |
| author_sort | Natasha Ali |
| collection | DOAJ |
| description | Objective: Treating Diffuse Large B-Cell Lymphoma (DLBCL) in elderly patients is challenging. There is limited data available from Low- and Middle-Income Countries (LMICs) on elderly DLBCL. We analyzed the presentations and survival outcomes of patients with DLBCL according to their socioeconomic status. Methodology: This was a multicenter retrospective study conducted from 2015 to 2023. We included 176 patients aged 60 years or older. The variables examined were age, gender, subtype, resource environment and treatment received. Kaplan-Meier curve was created for the entire patient cohort; t-test was utilized to compare means, Disease-Free Survival (DFS) and Overall Survival (OS), with a significance level of p < 0.05. Analysis was performed using SPSS version 29. Results: The median age was 66 years (range: 60–89 years). Ninety-three (57%) patients were treated in limited resource settings, while 43% had enhanced resources. ECOG performance scores between 2 and 3 were present in 71%. Median IPI score was 3. RCHOP regimen was administered to 51% (n = 81) patients, and CHOP regimen to 20% (n = 32) patients. In 21% (n = 38) salvage treatment was given due to relapsed/refractory disease. None of the patients in this group received consolidation with autologous stem cell transplant. The entire cohort’s OS was 12-months, while DFS was 8-months. OS (33.9% vs. 8.2%; p = 0.00) and DFS (29% vs. 5.9%; p = 0.00) were better in patients with enhanced resources. The median DFS of patients treated in enhanced settings was 1.3-years versus 0.4-years in limited resource settings (p < 0.0001) Conclusion: Survival rates were lower for patients receiving treatment in resource-limited settings. Outcomes can be improved with early referral and inclusion of Rituximab. Enhanced geriatric assessments along with better supportive care is essential. |
| format | Article |
| id | doaj-art-9154b372041d4c91b375303efe8df23b |
| institution | Kabale University |
| issn | 2531-1379 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Hematology, Transfusion and Cell Therapy |
| spelling | doaj-art-9154b372041d4c91b375303efe8df23b2025-08-20T03:31:31ZengElsevierHematology, Transfusion and Cell Therapy2531-13792025-07-014710389310.1016/j.htct.2025.103893OUTCOMES OF DIFFUSE LARGE B-CELL LYMPHOMA IN OLDER ADULTS TREATED IN RESOURCE-CONSTRAINED SETTINGSNatasha Ali0Raheel Iftikhar1Zeeshan Khan2Usman Ahmed3Humera Mahmood4Zeba Aziz5Aga Khan University Karachi, PakistanArmed Forces Bone Marrow Transplant Centre Rawalpindi, PakistanHameed Latif Hospital Lahore, PakistanShaukat Khanum Memorial Cancer Hospital & Research Center Lahore, PakistanNuclear Medicine, Oncology and Radiotherapy Institute Islamabad, PakistanHameed Latif Hospital Lahore, PakistanObjective: Treating Diffuse Large B-Cell Lymphoma (DLBCL) in elderly patients is challenging. There is limited data available from Low- and Middle-Income Countries (LMICs) on elderly DLBCL. We analyzed the presentations and survival outcomes of patients with DLBCL according to their socioeconomic status. Methodology: This was a multicenter retrospective study conducted from 2015 to 2023. We included 176 patients aged 60 years or older. The variables examined were age, gender, subtype, resource environment and treatment received. Kaplan-Meier curve was created for the entire patient cohort; t-test was utilized to compare means, Disease-Free Survival (DFS) and Overall Survival (OS), with a significance level of p < 0.05. Analysis was performed using SPSS version 29. Results: The median age was 66 years (range: 60–89 years). Ninety-three (57%) patients were treated in limited resource settings, while 43% had enhanced resources. ECOG performance scores between 2 and 3 were present in 71%. Median IPI score was 3. RCHOP regimen was administered to 51% (n = 81) patients, and CHOP regimen to 20% (n = 32) patients. In 21% (n = 38) salvage treatment was given due to relapsed/refractory disease. None of the patients in this group received consolidation with autologous stem cell transplant. The entire cohort’s OS was 12-months, while DFS was 8-months. OS (33.9% vs. 8.2%; p = 0.00) and DFS (29% vs. 5.9%; p = 0.00) were better in patients with enhanced resources. The median DFS of patients treated in enhanced settings was 1.3-years versus 0.4-years in limited resource settings (p < 0.0001) Conclusion: Survival rates were lower for patients receiving treatment in resource-limited settings. Outcomes can be improved with early referral and inclusion of Rituximab. Enhanced geriatric assessments along with better supportive care is essential.http://www.sciencedirect.com/science/article/pii/S2531137925001610 |
| spellingShingle | Natasha Ali Raheel Iftikhar Zeeshan Khan Usman Ahmed Humera Mahmood Zeba Aziz OUTCOMES OF DIFFUSE LARGE B-CELL LYMPHOMA IN OLDER ADULTS TREATED IN RESOURCE-CONSTRAINED SETTINGS Hematology, Transfusion and Cell Therapy |
| title | OUTCOMES OF DIFFUSE LARGE B-CELL LYMPHOMA IN OLDER ADULTS TREATED IN RESOURCE-CONSTRAINED SETTINGS |
| title_full | OUTCOMES OF DIFFUSE LARGE B-CELL LYMPHOMA IN OLDER ADULTS TREATED IN RESOURCE-CONSTRAINED SETTINGS |
| title_fullStr | OUTCOMES OF DIFFUSE LARGE B-CELL LYMPHOMA IN OLDER ADULTS TREATED IN RESOURCE-CONSTRAINED SETTINGS |
| title_full_unstemmed | OUTCOMES OF DIFFUSE LARGE B-CELL LYMPHOMA IN OLDER ADULTS TREATED IN RESOURCE-CONSTRAINED SETTINGS |
| title_short | OUTCOMES OF DIFFUSE LARGE B-CELL LYMPHOMA IN OLDER ADULTS TREATED IN RESOURCE-CONSTRAINED SETTINGS |
| title_sort | outcomes of diffuse large b cell lymphoma in older adults treated in resource constrained settings |
| url | http://www.sciencedirect.com/science/article/pii/S2531137925001610 |
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