Journal of Geriatric Oncology - Volume 7/6 - Supplement 1

A B S T R A C T S

S59

declared, J. Choi: None declared, A. Hurria Consultant for:

GTX, Boehringer Ingelheim Pharmaceuticals, Carevive, Sanofi

Keywords:

Breast cancer, chemotherpy, biomarkers of aging

P040

DIFFUSE LARGE B CELL LYMPHOMA: AN OVERVIEW OF

THE DISEASE WITH SPECIAL FOCUS ON CIRS SCALE AND

EMERGENCY VISITS IN THE ELDERLY POPULATION

C. Plaza Meneses

, T. Arquero Portero

, B. Zheng

M. Yuste Platero

, T. Villaescusa de la Rosa

J. L. Lopez Lorenzo

, M. A. Pérez Sáenz

, E. Prieto Pareja

F. Lobo Samper

, P. Llamas Sillero

, R. Cordóba Mascuñano

Hematology, Hospital Universitario Fundación Jiménez Díaz,

Madrid, Spain

Introduction:

Lymphomas are a very prevalent disease in the

elderly population.Many aggressive lymphomas are considered

nowadays to be a curable disease. All patients, even those older

than 60 years of age, are considered for optimal treatment with

a curative intent. Diffuse Large B Cell Lymphoma (DLBCL) is

the most common Non-Hodgkin Lymphoma (NHL), involving

around 4% of all malignancies diagnosed. It is considered an

aggressive lymphoma with 60% of curative rates after standard

treatment with R-CHOP regimen. Those patients that had

disease progression can be rescued with salvage treatment in

20-30% of cases. The elderly population is not considered for

full standard treatment in many centers. The use of geriatric

scales are starting to being used to stratify patients and offer

them a more individualized treatment regimen.

Objectives:

1: Validate CIRS score in DLBCL cohort. 2:

Impact of CIRS in treatment related complications (ER visits,

hospitalizations, length of stay). 3: Impact of CIRS score in OS

Methods:

We analyzed 41 patients homogeneously treated

with R-CHOP in a single center, with 60 years of age or older

at diagnosis between November 2008 and November 2015.

Patients were evaluated for comorbidities with Cumulative

Illness Rating Scale (CIRS), in order to try to detect the more

unfit population and evaluate the average of admissions,

length of stays and the impact on overall survival (OS). The

CIRS scale were adjusted by removing the hematological

question since all our patients were diagnosed with a

hematologic malignancy. The cutoff point for CIRS score was

selected using a ROC analysis.

Results:

In our series, 20 (48%) were males and 21 (52%) were

females. Median age at diagnosis was 73 years old (range 60-

90 years). With a median follow-up of 32 months (range 0-96),

the median PFS was 51 months and OS was 61 months. There

were 49 ER visits recorded. 10 patients (24%) did not require an

ER visit. Neutropenic fever was the most common cause of ER

visit, n=18 (36%). 25 (51%) of the patients were admitted in the

hospital, with an average of stay of 9.2 days (range 1-62). The

ROC analysis identified a scoring of 5.5 in CIRS score to identify

two different risk groups, with anAUC of 70.5% and a sensibility

of 87% and a specificity of 48% (p=0.02). The low risk group

(n=17), 7 (41%) patients were admitted with a mean of stay of

6.2 days of stay (range 1-16 days) the high risk group (n=24),

11 (45%) patients were admitted with a mean of stay of 10.6

days (range 1-62) with p=0.035. The CIRS scale was also used to

discriminate two OS groups, the low risk showed a median OS

of 77 months vs the high risk of 51 months of OS (p=0.05).

Conclusion:

The OS and the PFS in our sample is similar as

described in larger studies, with a great number of patients

Fig. 1 (abstract P040) – ROC curve and cut-off points for CIRS and overall survival.