Diffuse large B-cell lymphoma in elderly: Experience from a tertiary care oncology center in South India
Introduction: Diffuse large B-cell lymphoma (DLBCL) is the most frequent non-Hodgkins lymphoma in the elderly. With the rising proportion of older persons in India, it is important to study current patterns and management of this disease, given that data in this regard are scarce in Indian settings....
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Thieme Medical and Scientific Publishers Pvt. Ltd.
2017-01-01
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| Series: | South Asian Journal of Cancer |
| Subjects: | |
| Online Access: | http://journal.sajc.org/article.asp?issn=2278-330X;year=2017;volume=6;issue=2;spage=72;epage=74;aulast=Lokesh |
| _version_ | 1818391502896758784 |
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| author | K N Lokesh M C. Suresh Babu K C Lakshmaiah K Govind Babu Smitha C Saldanha D Loknatha Linu Abraham Jacob S Vishwanath C S Premalatha P R Kiran |
| author_facet | K N Lokesh M C. Suresh Babu K C Lakshmaiah K Govind Babu Smitha C Saldanha D Loknatha Linu Abraham Jacob S Vishwanath C S Premalatha P R Kiran |
| author_sort | K N Lokesh |
| collection | DOAJ |
| description | Introduction: Diffuse large B-cell lymphoma (DLBCL) is the most frequent non-Hodgkins lymphoma in the elderly. With the rising proportion of older persons in India, it is important to study current patterns and management of this disease, given that data in this regard are scarce in Indian settings. The aim of this study was to document the clinical features of DLBCL among elderly patients and their outcome over 7 years at a tertiary care oncology center. Materials and Methods: This was a retrospective records review of 119 DLBCL cases between January 2007 and January 2015 aged 60 years and above done at Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India. Clinical staging was done according to Ann Arbor staging as modified by Cotswold's and International Prognostic Index (IPI) calculated. Results: The mean age was 69.54 years (±5.44) with male: female ratio of 1.52:1. B symptoms were seen in 33% of patients. Thirty-six percent of the patients had stage II disease. The advanced stage was seen in 12% and bulky disease in 9.5%. Bone marrow was involved in 12%. The most common extranodal site was the head and neck region. The distribution according to the IPI was as follows: Low risk 38 (31.93%), low-intermediate risk 53 (44.54%), high-intermediate risk 20 (16.80%), and high risk 8 (6.72%). Among 119 patients, 98 (64.7%) received treatment with either combination of rituximab, cyclophosphamide, adriamycin, vincristine, epirubicin, and prednisolone. Overall response rate was 63.26% with a complete response rate of 38.77%. The overall survival ranged from 2 to 123 months with the median being 9.5 months. Conclusion: In elderly, DLBCL is common in seventh decade and most of them present in an early stage and low IPI. The incorporation of rituximab to anthracycline based chemotherapy shows a significant improvement in survival in elderly DLBCL. |
| first_indexed | 2024-12-14T05:14:33Z |
| format | Article |
| id | doaj.art-95d1cca37407480c949edb12719c213a |
| institution | Directory Open Access Journal |
| issn | 2278-330X |
| language | English |
| last_indexed | 2024-12-14T05:14:33Z |
| publishDate | 2017-01-01 |
| publisher | Thieme Medical and Scientific Publishers Pvt. Ltd. |
| record_format | Article |
| series | South Asian Journal of Cancer |
| spelling | doaj.art-95d1cca37407480c949edb12719c213a2022-12-21T23:15:52ZengThieme Medical and Scientific Publishers Pvt. Ltd.South Asian Journal of Cancer2278-330X2017-01-0162727410.4103/2278-330X.208847Diffuse large B-cell lymphoma in elderly: Experience from a tertiary care oncology center in South IndiaK N LokeshM C. Suresh BabuK C LakshmaiahK Govind BabuSmitha C SaldanhaD LoknathaLinu Abraham JacobS VishwanathC S PremalathaP R KiranIntroduction: Diffuse large B-cell lymphoma (DLBCL) is the most frequent non-Hodgkins lymphoma in the elderly. With the rising proportion of older persons in India, it is important to study current patterns and management of this disease, given that data in this regard are scarce in Indian settings. The aim of this study was to document the clinical features of DLBCL among elderly patients and their outcome over 7 years at a tertiary care oncology center. Materials and Methods: This was a retrospective records review of 119 DLBCL cases between January 2007 and January 2015 aged 60 years and above done at Kidwai Memorial Institute of Oncology, Bengaluru, Karnataka, India. Clinical staging was done according to Ann Arbor staging as modified by Cotswold's and International Prognostic Index (IPI) calculated. Results: The mean age was 69.54 years (±5.44) with male: female ratio of 1.52:1. B symptoms were seen in 33% of patients. Thirty-six percent of the patients had stage II disease. The advanced stage was seen in 12% and bulky disease in 9.5%. Bone marrow was involved in 12%. The most common extranodal site was the head and neck region. The distribution according to the IPI was as follows: Low risk 38 (31.93%), low-intermediate risk 53 (44.54%), high-intermediate risk 20 (16.80%), and high risk 8 (6.72%). Among 119 patients, 98 (64.7%) received treatment with either combination of rituximab, cyclophosphamide, adriamycin, vincristine, epirubicin, and prednisolone. Overall response rate was 63.26% with a complete response rate of 38.77%. The overall survival ranged from 2 to 123 months with the median being 9.5 months. Conclusion: In elderly, DLBCL is common in seventh decade and most of them present in an early stage and low IPI. The incorporation of rituximab to anthracycline based chemotherapy shows a significant improvement in survival in elderly DLBCL.http://journal.sajc.org/article.asp?issn=2278-330X;year=2017;volume=6;issue=2;spage=72;epage=74;aulast=LokeshCyclophosphamidediffuse large B-cell lymphomadoxorubicinIndiarelapseremissionrituximabvincristineprednisone |
| spellingShingle | K N Lokesh M C. Suresh Babu K C Lakshmaiah K Govind Babu Smitha C Saldanha D Loknatha Linu Abraham Jacob S Vishwanath C S Premalatha P R Kiran Diffuse large B-cell lymphoma in elderly: Experience from a tertiary care oncology center in South India South Asian Journal of Cancer Cyclophosphamide diffuse large B-cell lymphoma doxorubicin India relapse remission rituximab vincristine prednisone |
| title | Diffuse large B-cell lymphoma in elderly: Experience from a tertiary care oncology center in South India |
| title_full | Diffuse large B-cell lymphoma in elderly: Experience from a tertiary care oncology center in South India |
| title_fullStr | Diffuse large B-cell lymphoma in elderly: Experience from a tertiary care oncology center in South India |
| title_full_unstemmed | Diffuse large B-cell lymphoma in elderly: Experience from a tertiary care oncology center in South India |
| title_short | Diffuse large B-cell lymphoma in elderly: Experience from a tertiary care oncology center in South India |
| title_sort | diffuse large b cell lymphoma in elderly experience from a tertiary care oncology center in south india |
| topic | Cyclophosphamide diffuse large B-cell lymphoma doxorubicin India relapse remission rituximab vincristine prednisone |
| url | http://journal.sajc.org/article.asp?issn=2278-330X;year=2017;volume=6;issue=2;spage=72;epage=74;aulast=Lokesh |
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