Diffuse Large B-cell Lymphoma in Very Elderly Patients Older Than 80 Years: A Multicenter Retrospective Analysis of Clinical Characteristics, Treatment Patterns, and Outcome KCSG LY16-01.

e19031 Background: Treatment strategy for elderly patients older than 80 years with diffuse large B cell lymphoma (DLBCL) has not been established because of treatment intolerability and lack of the data. Methods: This multicenter retrospective study was conducted to investigate clinical characteristics, treatment patterns and outcome of patients older than 80 years at the diagnosis of DLBCL from 19 institutions in Korea between 2005 and 2016. Results: A total of 194 patients were identified (men: women 93:101). Median age was 83.3 years (range 80.1-95.7). 114 (59.3%) patients had an age-adjusted international prognostic index (aaIPI) score of 2-3 and 48 (24.7%) had Charlson index with a score 4 or more. R-CHOP was given in 124 (63.9%) cases, R-CVP in 13 cases, other chemotherapy in 17 cases, radiation alone in 9 cases, and surgery alone in 2 cases. 29 (14.9%) patients did not receive any treatment. The median cycle of chemotherapy was three (range 1-10). Only 43 patients completed planed cycles of treatment. The overall response rate of 105 evaluable patients was 91.4% (CR 41.9%, PR 49.5%). 29 patients died due to treatment-related toxicity (TRT) such as pneumonia and sepsis. 13 patients died due to TRT just after 1st cycle. Median overall survival was 14.0 months. Main causes of death were disease progression (30.8%) and treatment-related toxicities (27.1%). In multivariate analyses, overall survival was affected by aaIPI, hypoalbuminemia, elevated creatinine, and treatment. Conclusions: Age itself should not be a contraindication to treatment. However, since elderly patients show higher TRT due to infection, careful monitoring and dose modification of chemotherapeutic agents would be needed.