The effect of R-CHOP dose reduction on overall survival of elderly patients with DLBCL - comparative study.

R-CHOP is the standard therapy for patients with diffuse large B-cell lymphoma (DLBCL). We evaluated the effect of reduced intensity R-CHOP on survival, and toxicity in patients 70 years or older with DLBCL. The retrospective analysis included 140 patients (median age 78 years). We showed that patients with a good performance status treated with reduced adriamycin dose had a statistically significant worse overall survival. In multivariable model, the HR with any 10% increase adriamycin-relative dose in the first cycle was, 0.81, 95% CI 0.70-0.94. Age, gender, albumin and IPI were also associated with overall survival. Hospitalizations of patients treated with reduced R-CHOP were longer; however, the rate of infection did not differ between the groups. Based on current data, the optimal treatment for elderly patients with DLBCL remains unclear, but it is apparent that the dose of chemotherapy should be tailored individually according to performance status.