!
COMORBIDITY'AS'A'PROGNOSTIC'FACTOR'IN'THE'ELDERLY'PATIENT'WITH'
POSTER'47'
DIFFUSE'LARGE'BICELL'LYMPHOMA'
'
Karen! ValdesJDiaz,! Halbert! HernandezJNegrin,! Leonel! ValdesJLeiva! and! Dianelys! PedrazaJGonzalez,!
Arnaldo!Milian!!
!
Hospital,!Santa!Clara,!Cuba!
!
Purpose:! Diffuse! Large! BJCell! Lymphoma! (DCGB)! increases! with! age,! and! old! age! is!
associated!with!worse!outcomes.!Concomitant!diseases!at!the!time!of!diagnosis!are!related!
to! decisionJmaking! regarding! therapeutic! management! and! therefore! have! prognostic!
implications! for! this! age! group.! The! objective! of! this! study! is! to! determine! the! correlation!
between! comorbidity,! overall! survival,! and! response! to! treatment! in! older! adult! patients!
with! DCGB! lymphoma.! Methods:! We! retrospectively! analyzed! all! patients! older! than! 60!
years! with! a! diagnosis! of! DCGB! lymphoma,! in! the! period! between! 2004! and! 2019,! at! our!
institution.! To! determine! their! comorbidity,! the! ageJadjusted! Charlson! comorbidity! index!
was! calculated! in! each! patient! without! considering! the! underlying! oncohematological!
disease!and!subsequently!they!were!classified!into!groups!of!low!comorbidity!(1!or!2!points),!
high! comorbidity! (3! points! or! more)! and! absence! of! comorbidity.! Results:! A! total! of! 75!
patients! with! a! median! age! of! 70! years,!with! an! interquartile! range! of! 13! years.! FortyJfive!
patients! (60%)! were! treated! with! Cyclophosphamide,! Doxorubicin,! Vincristine! and!
Prednisone! (CHOP)! and! 41.3%! of! the! patients! had! a! high! comorbidity! according! to! the!
Charlson!classification.!The!overall!survival!rate!at!one!year!for!all!patients!was!44.6%,!with!a!
significant! difference! between! those! patients! who! had! a! low! and! intermediate! high! IPI!
(71.3%! versus! 15.4%,! p! <0.000).! Cox's! multivariate! proportional! hazards! analysis! identified!
that! patients! with! high! comorbidity! had! worse! overall! survival,! regardless! of! other!
prognostic! factors! that! make! up! the! IPI! (hazard! ratio! 2.73! with! a! 95%! confidence! interval!
1.26! to! 5! ,! 9,! p! =! 0.01).! In! contrast,! the! high! comorbidity! group! presented! a! therapeutic!
response! rate! (27.3%! versus! 72.7%,! p! equal! to! 0.013)! and! an! overall! survival! at! one! year!
(14.6%!versus!66.8%,!p!=!0.000)!significantly!less!than!that!of!no!comorbidity.!Conclusions:!
Among!those!patients!with!DLBCL,!high!comorbidity!was!significantly!associated!with!worse!
survival! and! therapeutic! response.! Comprehensive! strategies! are! necessary! in! the!
management!of!the!elderly!that!include!the!evaluation!of!the!comorbid!state!in!the!making!
of!therapeutic!decisions.!
! !