Feasibility of Quality of Life Assessment in Patients with Lymphoma Aged ≥80 Years Receiving Reduced-Intensity Chemotherapy: A Single-Institute Study
Abstract
:1. Introduction
2. Patients and Methods
2.1. Study Oversight
2.2. Patient Selection
2.3. Treatment
2.4. Efficacy Evaluation
2.5. Statistical Methods
3. Results
3.1. Patient Characteristics
3.2. Toxicity Assessments
3.3. QOL
4. Discussion
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
- Gwaltney, C.J.; Shields, A.L.; Shiffman, S. Equivalence of electronic and paper-and pencil administration of patient-reported outcome measures: A meta-analytic re-view. Value Health 2008, 11, 322–333. [Google Scholar] [CrossRef] [PubMed]
- Peyrade, F.; Jardin, F.; Thieblemont, C.; Thyss, A.; Emile, J.-F.; Castaigne, S.; Coiffier, B.; Haioun, C.; Bologna, S.; Fitoussi, O.; et al. Attenuated immunochemotherapy regimen (R-miniCHOP) in elderly patients older than 80 years with diffuse large B-cell lymphoma: A multicentre, single-arm, phase 2 trial. Lancet Oncol. 2011, 12, 460–468. [Google Scholar] [CrossRef] [PubMed]
- Peyrade, F.; Bologna, S.; Delwail, V.; Emile, J.F.; Pascal, L.; Fermé, C.; Schiano, J.-M.; Coiffier, B.; Corront, B.; Farhat, H.; et al. Combination of ofatumumab and reduced-dose CHOP for diffuse large B-cell lymphomas in patients aged 80 years or older: An open-label, multicentre, single-arm, phase 2 trial from the LYSA group. Lancet Haematol. 2017, 4, e46–e55. [Google Scholar] [CrossRef] [PubMed]
- Di Maio, M.; Basch, E.; Denis, F.; Fallowfield, L.; Ganz, P.; Howell, D.; Kowalski, C.; Perrone, F.; Stover, A.; Sundaresan, P.; et al. The role of patient-reported outcome measures in the continuum of cancer clinical care: ESMO Clinical Practice Guideline. Ann. Oncol. 2022, 33, 878–892. [Google Scholar] [CrossRef] [PubMed]
- Kim, A.; Chung, K.C.; Keir, C.; Patrick, D.L. Patient-reported outcomes associated with cancer screening: A systematic review. BMC Cancer 2022, 22, 223. [Google Scholar] [CrossRef]
- Carson, K.R.; Riedell, P.; Lynch, R.; Nabhan, C.; Wildes, T.M.; Liu, W.; Ganti, A.; Roop, R.; Sanfilippo, K.M.; O’Brian, K.; et al. Comparative effectiveness of anthracycline-containing chemotherapy in United States veterans age 80 and older with diffuse large B-cell lymphoma. J. Geriatr. Oncol. 2015, 6, 211–218. [Google Scholar] [CrossRef]
- Husson, O.; de Rooij, B.H.; Kieffer, J.; Oerlemans, S.; Mols, F.; Aaronson, N.K.; van der Graaf, W.T.; van de Poll-Franse, L.V. The EORTC QLQ-C30 summary score as prognostic factor for survival of patients with cancer in the “real-world”: Results from the population-based profiles registry. Oncologist 2020, 25, e722–e732. [Google Scholar] [CrossRef]
- McGarrah, P.; Hubbard, J.; Novotny, P.J.; Branda, M.E.; Sargent, D.S.; Morton, R.F.; Fuchs, C.S.; Benson, A.B.; Williamson, S.K.; Findlay, B.P.; et al. Baseline Quality of Life is a Strong and Independent Prognostic Factor for Overall Survival in Metastatic Colorectal Cancer. Cancer Control 2023, 30, 10732748231185047. [Google Scholar] [CrossRef]
- Tucci, A.; Ferrari, S.; Bottelli, C.; Borlenghi, E.; Drera, M.; Rossi, G. A comprehensive geriatric assessment is more effective than clinical judgment to identify elderly diffuse large cell lymphoma patients who benefit from aggressive therapy. Cancer 2009, 115, 4547–4553. [Google Scholar] [CrossRef]
- Mohile, S.G.; Dale, W.; Somerfield, M.R.; Schonberg, M.A.; Boyd, C.M.; Burhenn, P.S.; Canin, B.; Cohen, H.J.; Holmes, H.M.; Hopkins, J.O.; et al. Practical Assessment and Management of Vulnerabilities in Older Patients Receiving Chemotherapy: ASCO Guideline for Geriatric Oncology. J. Clin. Oncol. 2018, 36, 2326–2347. [Google Scholar] [CrossRef]
- Bai, J.-F.; Han, H.-X.; Feng, R.; Li, J.-T.; Wang, T.; Zhang, C.-L.; Liu, H. Comprehensive Geriatric Assessment (CGA): A Simple Tool for Guiding the Treatment of Older Adults with Diffuse Large B-Cell Lymphoma in China. Oncologist 2020, 25, e1202–e1208. [Google Scholar] [CrossRef] [PubMed]
- Swerdlow, S.H.; Campo, E.; Pileri, S.A.; Harris, N.L.; Stein, H.; Siebert, R.; Advani, R.; Ghielmini, M.; Salles, G.A.; Zelenetz, A.D.; et al. The 2016 revision of the World Health Organization classification of lymphoid neoplasms. Blood 2016, 127, 2375–2390. [Google Scholar] [CrossRef] [PubMed]
- Martinez-Tapia, C.; Paillaud, E.; Liuu, E.; Tournigand, C.; Ibrahim, R.; Fossey-Diaz, V.; Culine, S.; Canoui-Poitrine, F.; Audureau, E.; Caillet, P.; et al. Prognostic value of the G8 and modified-G8 screening tools for multidimensional health problems in older patients with cancer. Eur. J. Cancer 2017, 83, 211–219. [Google Scholar] [CrossRef]
- Lawton, M.P.; Brody, E.M. Assessment of older people: Self-maintaining and instrumental activities of daily living. Gerontologist 1969, 9, 179–186. [Google Scholar] [CrossRef] [PubMed]
- Charlson, M.E.; Pompei, P.; Ales, K.L.; MacKenzie, C.R. A new method of classifying prognostic comorbidity in longitudinal studies: Development and validation. J. Chronic Dis. 1987, 40, 373–383. [Google Scholar] [CrossRef] [PubMed]
- Sehn, L.H.; Berry, B.; Chhanabhai, M.; Fitzgerald, C.; Gill, K.; Hoskins, P.; Klasa, R.; Savage, K.J.; Shenkier, T.; Sutherland, J.; et al. The revised International Prognostic Index (R-IPI) is a better predictor of outcome than the standard IPI for patients with diffuse large B-cell lymphoma treated with R-CHOP. Blood 2007, 109, 1857–1861. [Google Scholar] [CrossRef]
- Cheson, B.D.; Pfistner, B.; Juweid, M.E.; Gascoyne, R.D.; Specht, L.; Horning, S.J.; Coiffier, B.; Fisher, R.I.; Hagenbeek, A.; Zucca, E.; et al. Revised response criteria for malignant lymphoma. J. Clin. Oncol. 2007, 25, 579–586. [Google Scholar] [CrossRef]
- Kanda, Y. Investigation of the freely available easy-to-use software ‘EZR’ for medical statistics. Bone Marrow Transplant. 2013, 48, 452–458. [Google Scholar] [CrossRef]
- Yamasaki, S.; Matsushima, T.; Minami, M.; Kadowaki, M.; Takase, K.; Iwasaki, H. Clinical impact of comprehensive geriatric assessment in patients aged 80 years and older with diffuse large B-cell lymphoma receiving rituximab-mini-CHOP: A single-institute retrospective study. Eur. Geriatr. Med. 2022, 13, 195–201. [Google Scholar] [CrossRef]
- Pergolotti, M.; Deal, A.M.; Williams, G.R.; Bryant, A.L.; Bensen, J.T.; Muss, H.B.; Reeve, B.B. Activities, function, and health-related quality of life (HRQOL) of older adults with cancer. J. Geriatr. Oncol. 2017, 8, 249–254. [Google Scholar] [CrossRef]
- Li, D.; Sun, C.-L.; Kim, H.; Soto-Perez-De-Celis, E.; Chung, V.; Koczywas, M.; Fakih, M.; Chao, J.; Chien, L.C.; Charles, K.; et al. Geriatric Assessment–Driven Intervention (GAIN) on Chemotherapy-Related Toxic Effects in Older Adults with Cancer: A Randomized Clinical Trial. JAMA Oncol. 2021, 7, e214158. [Google Scholar] [CrossRef] [PubMed]
- Bataillard, E.J.; Cheah, C.Y.; Maurer, M.J.; Khurana, A.; Eyre, T.A.; El-Galaly, T.C. Impact of R-CHOP dose intensity on survival outcomes in diffuse large B-cell lymphoma: A systematic review. Blood Adv. 2021, 5, 2426–2437. [Google Scholar] [CrossRef] [PubMed]
- Rozental, A.; Jim, H.S.L.; Extermann, M. Treatment of older patients with mantle cell lymphoma in the era of novel agents. Leuk. Lymphoma 2023, 64, 1514–1526. [Google Scholar] [CrossRef] [PubMed]
- Arcari, A.; Cavallo, F.; Puccini, B.; Vallisa, D. New treatment options in elderly patients with Diffuse Large B-cell Lymphoma. Front. Oncol. 2023, 13, 1214026. [Google Scholar] [CrossRef]
Characteristic | DLBCL | MCL | AITL | ATLL | |
---|---|---|---|---|---|
n = 4 | n = 3 | n = 3 | n = 3 | ||
Median age (range), years | 84 (80–93) | 84 (80–88) | 87 (82–90) | 81 (80–82) | |
>85 years old, n (%) | 2 (50) | 1 (25) | 2 (67) | 0 | |
Sex, n (%) | male | 2 (50) | 2 (67) | 1 (33) | 1 (33) |
female | 2 (50) | 1 (33) | 2 (67) | 2 (67) | |
ECOG PS, n (%) | 1 | 2 (50) | 2 (67) | 1 (33) | 2 (67) |
2 | 2 (50) | 1 (33) | 1 (33) | 1 (33) | |
3 | 0 | 0 | 1 (33) | 0 | |
G8, median (range) | 7 (7–9) | 8 (6–9) | 6 (4–8) | 8 (7–9) | |
IADL, median (range) | 2 | 2 | 2 | 2 | |
CCI, median (range) | 2 (2–3) | 3 (2–4) | 3 (2–3) | 2 (2–4) | |
Ann Arbor stage IV at diagnosis, n (%) | 4 (100) | 3 (100) | 3 (100) | 3 (100) | |
BM involvement, n (%) | 2 (50) | 3 (100) | 3 (100) | 3 (100) | |
LDH elevation, n (%) | 4 (100) | 3 (100) | 3 (100) | 3 (100) | |
ALB, median (range), g/dL | 2.9 (2.5–3.2) | 3.0 (2.3–3.2) | 2.6 (2.4–2.8) | 2.4 (2.2–2.5) | |
ALB >2.8 g/dL | 3 (75) | 2 (67) | 1 (33) | 0 | |
Hemoglobin, median (range), g/dL | 10.3 (6.2–12.5) | 9.5 (7.2–11.2) | 8.2 (5.8–10.2) | 7.8 (6.1–9.8) | |
Hemoglobin < 12 g/dL | 3 (75) | 3 (100) | 3 (100) | 3 (100) | |
β2M, median (range), mg/L | 2.7 (2.5–3.0) | 3.2 (2.4–3.5) | 3.2 (2.4–3.6) | 3.0 (2.5–3.5) | |
β2M > 3.0 mg/L | 1 (25) | 2 (67) | 2 (67) | 2 (67) | |
sIL-2R, median (range), ×103 U/mL | 1.9 (1.5–3.2) | 4.5 (3.5–5.6) | 1.2 (1.1–1.3) | 23 (11–25) | |
IPI, n (%) | Low (0–1) | 1 (25) | 2 (67) | 0 | 1 (33) |
Intermediate (2–3) | 3 (75) | 1 (33) | 3 (100) | 2 (67) | |
No. of cycles of initial chemotherapy, median (range) | 3 (1–6) | 6 (1–8) | 6 (1–8) | 6 (6–8) | |
≥6 cycles, n (%) | 2 (50) | 2 (67) | 2 (67) | 3 (100) | |
ORR, n (%) | 2 (50) | 2 (67) | 2 (67) | 3 (100) | |
Relapse/progression, n (%) | 2 (50) | 1 (33) | 1 (33) | 0 | |
Death due to lymphoma, n (%) | 2 (50) | 1 (33) | 1 (33) | 0 | |
Median (range) follow-up, months | 7 (1–13) | 12 (3–13) | 12 (1–13) | 13 (12–13) |
Toxicity | DLBCL | MCL | AITL | ATLL |
---|---|---|---|---|
n = 4 | n = 4 | n = 3 | n = 3 | |
Hematological toxicities, n (%) | ||||
WBC count decreased | 2 (50) | 2 (50) | 3 (100) | 3 (100) |
Neutrophil count decreased | 2 (50) | 2 (50) | 3 (100) | 3 (100) |
Lymphocyte count decreased | 0 | 1 (25) | 1 (33) | 3 (100) |
Anemia | 2 (50) | 2 (50) | 2 (67) | 3 (100) |
Infections, n (%) | ||||
Febrile neutropenia | 2 (50) | 2 (50) | 1 (33) | 3 (100) |
Pneumonia | 0 | 0 | 1 (25) | 1 (25) |
Non-hematological toxicities, n (%) | ||||
Gastrointestinal | ||||
Anorexia | 0 | 0 | 1 (33) | 1 (33) |
Nausea | 0 | 0 | 1 (33) | 1 (33) |
Neurological | ||||
Peripheral sensory neuropathy | 0 | 1 (25) | 1 (33) | 1 (33) |
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Yamasaki, S. Feasibility of Quality of Life Assessment in Patients with Lymphoma Aged ≥80 Years Receiving Reduced-Intensity Chemotherapy: A Single-Institute Study. Hematol. Rep. 2024, 16, 1-10. https://doi.org/10.3390/hematolrep16010001
Yamasaki S. Feasibility of Quality of Life Assessment in Patients with Lymphoma Aged ≥80 Years Receiving Reduced-Intensity Chemotherapy: A Single-Institute Study. Hematology Reports. 2024; 16(1):1-10. https://doi.org/10.3390/hematolrep16010001
Chicago/Turabian StyleYamasaki, Satoshi. 2024. "Feasibility of Quality of Life Assessment in Patients with Lymphoma Aged ≥80 Years Receiving Reduced-Intensity Chemotherapy: A Single-Institute Study" Hematology Reports 16, no. 1: 1-10. https://doi.org/10.3390/hematolrep16010001