ArticleJournal of geriatric oncology2015
Comparative effectiveness of anthracycline-containing chemotherapy in United States veterans age 80 and older with diffuse large B-cell lymphoma.
Article in Journal of geriatric oncology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
29 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- The management of newly diagnosed large B-cell lymphoma: A British Society for Haematology Guideline.British journal of haematology · 2024Guideline
- Impact of R-CHOP dose intensity on survival outcomes in diffuse large B-cell lymphoma: a systematic review.Blood advances · 2021Pooled it
- Pooled it
- Patterns of growth factor usage and febrile neutropenia among older patients with diffuse large B-cell non-Hodgkin lymphoma treated with CHOP or R-CHOP: the Intergroup experience (CALGB 9793; ECOG-SWOG 4494).Leukemia & lymphoma · 2017Trial
- Comparison of Three Chemotherapy Regimens in Elderly Patients with Diffuse Large B Cell Lymphoma: Experience at a Single National Reference Center in Mexico.BioMed research international · 2016Trial
- JSH practical guidelines for hematological malignancies, 2023: II. Lymphoma5. Diffuse large B-cell lymphoma, not otherwise specified (DLBCL, NOS).International journal of hematology · 2025Article
- Incidence and risk factors of severe infections in diffuse large B-cell lymphoma patients undergoing immunochemotherapy.Annals of hematology · 2025Article
- Prephase steroid use and association with dose delays and outcomes in a real-world cohort of older adults treated for diffuse large B-cell lymphoma.Leukemia & lymphoma · 2025Article
- Determination and Management of Risks for Practices and Procedures in the Elderly (DRIPP): the impact of a comprehensive geriatric evaluation in elderly with diffuse large B-cell lymphoma.Hematology, transfusion and cell therapy · 2024Article
- Geriatric risk model for older patients with diffuse large B-cell lymphoma (GERIAD): a prospective multicenter cohort study.The Korean journal of internal medicine · 2024Article
- Decreasing polypharmacy in older adults with cancer: A pilot cluster-randomized trial protocol.Journal of geriatric oncology · 2024Article
- Feasibility of Quality of Life Assessment in Patients with Lymphoma Aged ≥80 Years Receiving Reduced-Intensity Chemotherapy: A Single-Institute Study.Hematology reports · 2023Article
- Supportive Care in Older Lymphoma Patients to Reduce Toxicity and Preserve Quality of Life.Cancers · 2023Review
- The Relative Dose Intensity Changes during Cycles of Standard Regimens in Patients with Diffuse Large B-Cell Lymphoma.Cancers · 2023Article
- Reduced-Intensity Anthracycline-Free Chemoimmunotherapy in Elderly Patients With Newly Diagnosed or Relapsed Diffuse Large B-Cell Lymphoma.Journal of hematology · 2023Article
- Utility of the frailty score for predicting prognosis and individualizing treatment intensity in elderly patients with diffuse large B cell lymphoma.Annals of hematology · 2023Article
- Factors Associated with Discontinuation of Statin Therapy in Patients with Lymphoma Aged 80 Years and Older: A Retrospective Single-Institute Study.Drugs - real world outcomes · 2022Article
- Assessing frailty using comprehensive geriatric assessment in older patients with hematologic malignancy.Blood research · 2022Review
- A simplified frailty score predicts survival and can aid treatment-intensity decisions in older patients with DLBCL.Blood advances · 2021Article
- Infection-related morbidity and mortality among older patients with DLBCL treated with full- or attenuated-dose R-CHOP.Blood advances · 2021Article
Corrections and comments
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Authors and funding
16 authors.
Funding
Abstract
objectivesWhile anthracycline-based treatment can cure diffuse large B-cell lymphoma, most patients over age 80 do not receive doxorubicin due to toxicity concerns. This study evaluated this practice, as patients age 80 and older are largely excluded from clinical trials. The primary outcome of interest was overall survival. Secondary outcomes included treatment-related mortality and anthracycline dose intensity. MATERIALS AND
methodsWe assembled a cohort of 530 newly diagnosed diffuse large B-cell lymphoma patients age 80 or older diagnosed within United States Veterans Health Administration. Treatment and survival information were obtained to determine associations between anthracycline use, dose intensity, treatment-related mortality and overall survival.
resultsOf the 530 patients, 285 received systemic treatment and 193 received an anthracycline. After controlling for potential confounders, rituximab decreased mortality (hazard ratio, 0.62; 95% confidence interval [CI]: 0.44-0.88), while doxorubicin was not significantly associated with mortality (hazard ratio, 0.87; 95% CI: 0.64-1.17). Completion of treatment with anthracycline dose intensity ≥85% of expected was only 14%. Patients treated with anthracycline dose intensity <85% had better one year survival compared to those treated at ≥85% (70% vs. 59%, p=0.029).
conclusionThese results suggest that full dose anthracycline therapy may be less important in the treatment of diffuse large B-cell lymphoma patients over age 80. The low frequency of completion of full dose intensity treatment suggests that standard doses are an unrealistic standard of care for patients this age. Alternate treatment strategies and risk stratification should be considered for these patients.
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