ArticleAnnals of hematology2026
Low serum albumin levels and the nongerminal center B-cell subtype according to the Hans algorithm as strong prognostic factors in ≥ 80-year-old patients with large B-cell lymphoma treated with rituximab-containing chemotherapy.
Article in Annals of hematology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Large B-cell lymphoma (LBCL) frequently affects very elderly patients, and treatment decisions for those aged ≥ 80 years are complicated by heterogeneity in frailty. Evidence focusing specifically on prognostic factors in this age group treated with rituximab-containing chemotherapy remains limited. In this study, we retrospectively analyzed 137 patients aged ≥ 80 years with LBCL who received rituximab-based chemotherapy at our institution to identify prognostic factors. The median age was 83 years. Of 137 patients, 51 (37.2%) were > 85 years, and 92 (67.0%) were classified as high-risk by the elderly prognostic index. Cell of origin was determined in 109 patients (79.6%) using the Hans classifier: 46 (33.6%) were germinal center B-cell (GCB) subtype and 63 (46.0%) non-GCB. Median serum albumin at diagnosis was 3.50 g/dL (range, 1.70–4.80). First-line therapies included R-CHOP in 93 patients (67.9%), R-THP-COP in 30 (21.9%), Pola-R-CHP in 4 (2.9%), DA-EPOCH-R in 3 (3.2%), and rituximab monotherapy in 7 (5.1%). The 2-year overall survival (OS) and progression-free survival (PFS) rates were 58.1% and 48.1%, respectively. Multivariate analysis identified four independent adverse prognostic factors for both OS and PFS: age ≥ 85 years (OS HR 2.25, PFS HR 2.11), serum serum albumin < 3.5 g/dL (OS HR 2.25, PFS HR 2.46), non-GCB (OS HR 2.20, PFS HR 2.21) and EPI-high-risk (OS HR 2.83, PFS HR 1.81). In LBCL patients aged ≥ 80 years treated with rituximab-containing chemotherapy, low serum albumin and non-GCB subtype are independent adverse prognostic factors. These accessible indicators should inform treatment eligibility decisions in very elderly patients.
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