Influence of Treatment Intensity and Medical Comorbidities in Older Adults With Peripheral T Cell Lymphoma

Authors

Max J Gordon
Zhigang Duan
Hui Zhao
Loretta Nastoupil
Samuel Ng
Alexey V Danilov
Swaminathan Iyer
Sharon H Giordano

Publication Date

12-1-2023

Journal

Leukemia & Lymphoma

Abstract

We conducted a population-based study of patients >65 years, diagnosed 2008-2017, with peripheral T-cell lymphoma (PTCL) using SEER-Medicare. Associations between PTCL subtype, treatment regimen, comorbidity, and mortality were assessed using the Kaplan-Meier method and multivariable Cox regression. Amongst the 2,546 patients, the median age was 77 years (interquartile range, 71-83). 5-year overall survival (OS) ranged from 22.2% to 37.3% depending on PTCL subtype. The most common frontline regimen was cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP). 5-year OS rate was 47.0% for patients treated with etoposide + CHOP (N = 67; CHOEP), 33.7% for those treated with CHOP (N = 732), and 23.8% for patients treated with non-anthracycline-containing regimens (N = 105; p < 0.001). In patients without comorbidities, CHOEP remained independently associated with improved OS (HR 0.52, 95% CI,0.30-0.91). Median OS was 1.2 years from initiation of second-line therapy (N = 228) independent of treatment regimen. Frontline but not second-line treatment regimen is associated with OS in older patients with PTCL.

Keywords

Humans, Aged, United States, Lymphoma, T-Cell, Peripheral, Medicare, Doxorubicin, Vincristine, Cyclophosphamide, Prednisone, Comorbidity, Antineoplastic Combined Chemotherapy Protocols, Peripheral T-cell lymphoma (PTCL), Geriatric oncology, Targeted therapy, Stem cell transplant, Comorbidity

DOI

10.1080/10428194.2023.2256908

PMID

37706491

PMCID

PMC10841322

PubMedCentral® Posted Date

12-1-2024

PubMedCentral® Full Text Version

Author MSS

Published Open-Access

yes