Clinical Outcomes of Pola-R-CHP Therapy in Patients Aged >80 Years With Diffuse Large B-Cell Lymphoma

Polatuzumab vedotin, rituximab, cyclophosphamide, doxorubicin, and prednisone (Pola-R-CHP) therapy has become a frontline treatment for diffuse large B-cell lymphoma (DLBCL), although evidence from patients aged >80 years remains limited. This study evaluated the real-world efficacy and safety of Pola-R-CHP therapy in patients older than 80 years.

We retrospectively analyzed 65 consecutive patients with newly diagnosed DLBCL who received Pola-R-CHP as first-line therapy. Patients were stratified by age into those ≤80 years (n=49) and >80 years (n=16). The primary endpoint was progression-free survival (PFS). Secondary endpoints included overall survival (OS), event-free survival (EFS), objective response rate (ORR), complete response rate (CRR), and safety. Dose intensity and adverse events were evaluated and compared between groups.

Patients aged >80 years received significantly lower dose intensities of cyclophosphamide and doxorubicin, whereas polatuzumab vedotin was administered at near-full dose intensity. Age >80 years was not independently associated with inferior PFS, OS, or EFS [PFS: hazard ratio (HR)=0.44, 95% confidence interval (CI)=0.10-1.94, p=0.28; OS: HR=0.82, 95%CI=0.17-3.88, p=0.80; EFS: HR=1.02, 95%CI=0.37-2.80, p=0.96]. ORR and CRR were comparable between the ≤80 and >80 years groups (ORR: 85.7% vs. 93.8%, p=0.67; CRR: 79.6% vs. 75.0%, p=0.73). Hematologic toxicities and febrile neutropenia occurred frequently, yet were comparable between groups, with no treatment-related deaths observed.

Pola-R-CHP therapy demonstrated efficacy and acceptable safety in patients >80 years with newly diagnosed DLBCL. With appropriate dose modification and supportive care, Pola-R-CHP therapy is a feasible frontline treatment for elderly patients in real-world clinical practice.