Outcomes of older patients with follicular lymphoma using individual data from 5922 patients in 18 randomized controlled trials

Casulo, Carla; Dixon, Jesse G.; Ou, Fang-Shu; Hoster, Eva; Peterson, Bruce A.; Hochster, Howard S.; Brice, Pauline; Ladetto, Marco; Hiddemann, Wolfgang; Marcus, Robert; Kimby, Eva; Herold, Michael; Nielsen, Tina; Morschhauser, Franck; Rummel, Mathias; Hagenbeek, Anton; Vitolo, Umberto; Salles, Gilles A.; Shi, Qian und Flowers, Christopher R. (2021): Outcomes of older patients with follicular lymphoma using individual data from 5922 patients in 18 randomized controlled trials. In: Blood Advances, Bd. 5, Nr. 6: S. 1737-1745

Abstract

Limited data exist to describe the clinical features and outcomes for elderly patients with follicular lymphoma (FL). The Follicular Lymphoma Analysis of Surrogacy Hypothesis (FLASH) group performed a prospectively planned pooled analysis of individual patient data from first-line randomized controlled trials (RCTs) and examined associations between age (<= 70 vs >70 years), clinical characteristics, and FL outcomes. We identified 18 multicenter clinical RCTs in the FLASH database that enrolled elderly patients (>70 years). Primary end points were early disease outcomes, CR24 and CR30, and progression-free survival (PFS) at 24 months (PFS24). Secondary end points were PFS and overall survival (OS). We identified 5922 previously untreated FL patients from 18 RCTs. Patients age >70 years (vs <= 70 years) more commonly had elevated lactate dehydrogenase, hemoglobin,12 g/dL, ECOG PS >= 2, and elevated beta 2-microglobulin. Median follow-up was 5.6 years. Patients >70 years did not differ from patients <= 70 years in rates of CR24, CR30, or PFS24. With a median OS of 14.6 years for all patients, median OS was 7.4 and 15.7 years for patients >70 and <= 70 years of age, respectively (hazard ratio = 2.35;95% confidence interval = 2.03-2.73;P < .001). Age >70 years was a significant predictor of OS and PFS due to higher rates of death without progression, but not PFS24, CR24, or CR30. FL patients >70 years treated on trials have similar early disease outcomes to younger patients. There is no disease-specific outcome difference between age groups. Age alone should not disqualify patients from standard treatments or RCTs.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 2473-9529
• Sprache: Englisch