Abstract
Introduction: Diffuse large B-cell
lymphoma (DLBCL) is the most frequent non-Hodgkins
lymphoma in the elderly. With the rising
proportion of older persons in India, it is
important to study current patterns and management
of this disease, given that data in this regard
are scarce in Indian settings. The aim of this
study was to document the clinical features of
DLBCL among elderly patients and their outcome
over 7 years at a tertiary care oncology center.
Materials and Methods: This was a retrospective
records review of 119 DLBCL cases between January
2007 and January 2015 aged 60 years and above done
at Kidwai Memorial Institute of Oncology,
Bengaluru, Karnataka, India. Clinical staging was
done according to Ann Arbor staging as modified by
Cotswold's and International Prognostic Index
(IPI) calculated. Results: The mean age was 69.54
years (±5.44) with male: female ratio of 1.52:1. B
symptoms were seen in 33% of patients. Thirty-six
percent of the patients had stage II disease. The
advanced stage was seen in 12% and bulky disease
in 9.5%. Bone marrow was involved in 12%. The most
common extranodal site was the head and neck
region. The distribution according to the IPI was
as follows: Low risk 38 (31.93%), low-intermediate
risk 53 (44.54%), high-intermediate risk 20
(16.80%), and high risk 8 (6.72%). Among 119
patients, 98 (64.7%) received treatment with
either combination of rituximab, cyclophosphamide,
adriamycin, vincristine, epirubicin, and
prednisolone. Overall response rate was 63.26%
with a complete response rate of 38.77%. The
overall survival ranged from 2 to 123 months with
the median being 9.5 months. Conclusion: In
elderly, DLBCL is common in seventh decade and
most of them present in an early stage and low
IPI. The incorporation of rituximab to
anthracycline based chemotherapy shows a
significant improvement in survival in elderly
DLBCL.
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