Safety profiles in elderly patients with DLBCL on first-line Pola-R-CHP: a claims database study in Japan

Polatuzumab vedotin combined with rituximab, cyclophosphamide, doxorubicin, and prednisone (Pola-R-CHP) is approved for the treatment of untreated diffuse large B-cell lymphoma (DLBCL); however, safety data in patients aged ≥80 years remain limited. This observational study analyzed Japanese claims data (August 2022-September 2023) to assess safety outcomes in 2,452 patients receiving first-line Pola-R-CHP (n = 843) or R-CHOP (n = 1,609), including 153 and 449 patients aged ≥80 years, respectively. The study focused on infectious events, including febrile neutropenia (FN). FN incidence in patients aged ≥80 years (Pola-R-CHP, 22.9%; R-CHOP, 22.5%) was lower than in those aged 70-79 years (29.7% and 28.5%). This likely reflects strategic dose reductions from Cycle 1, with 92.1% and 97.2% of elderly patients receiving reduced doxorubicin doses, compared with 43.2% and 53.3% in their 70s. With proactive dose adjustments, the safety profile of Pola-R-CHP in patients aged ≥80 years was manageable and comparable to that of younger groups and R-CHOP.