Analysis of Clinical Factors and Mortality in Diffuse Large B-cell Lymphoma Patients Over or Under 80 Years of Age

Background: The prognosis of diffuse large B-cell lymphoma (DLBCL) is remarkably improved after R-CHOP therapy. However, there are few detailed reports regarding very elderly DLBCL patients. We investigated relationships between prognostic factors and mortality risk in DLBCL patients, especially those aged 80 years or more. Methods: The study subjects consisted of 141 patients newly-diagnosed with de novo DLBCL. Information regarding age, sex, stage, performance status (PS), lactate dehydrogenase (LDH), extranodal (EN) involvement, and therapies was available. Results: For the 141 patients, the female sex was significantly inversely related to mortality, whereas age ≥80 years, PS ≥2, and non-standard therapy were significantly positively associated with death. No associations were observed between death and stage, LDH, or EN. When classifying patients by age (<80 [n = 108] and ≥80 [n = 33] years), a significant inverse association between female sex and mortality was found only in the latter (very elderly) group. Positive relationships of PS ≥2 with mortality was more pronounced in patients ≥80 years of age than in those <80 years of age. A significant positive relationship with non-standard therapy was found only in patients <80 years of age. Conclusion: PS ≥2 may be positively associated with mortality, regardless of age. Female sex may be inversely related to mortality only in DLBCL patients aged 80 years or more, possibly due to the difference in rituximab clearance between the two study groups.