Relative Dose Intensity and Survival Outcomes in Older Adults With Lymphoma: A Single-Center Retrospective Analysis

Area of Science:

• Geriatric Oncology
• Hematologic Malignancies
• Clinical Trial Design

Background:

• Treatment intensity for lymphoma in older adults is often reduced due to frailty and comorbidities.
• The predictive value of chronological age versus delivered treatment intensity on outcomes remains unclear.

Purpose of the Study:

• To investigate whether chronological age or relative dose intensity (RDI) better predicts outcomes in older adults with lymphoma.
• To assess the association between RDI and progression-free survival (PFS) and overall survival (OS) in this patient population.

Main Methods:

• Retrospective review of 79 patients aged 65 years and older with newly diagnosed lymphoma receiving first-line therapy.
• Analysis of PFS and OS, with RDI effects expressed as hazard ratios (HRs) per 10%-point increase.
• Cox models adjusted for age, comorbidities, performance status, and specific lymphoma subtypes like diffuse large B-cell lymphoma (DLBCL).

Main Results:

• Median RDI was lower in patients aged 75 years and older compared to those aged 65-74 years.
• Higher RDI was independently associated with longer PFS in the overall cohort (HR, 0.709; p=0.001).
• In the DLBCL subgroup, higher RDI was associated with both longer PFS (HR, 0.217; p<0.001) and OS (HR, 0.320; p=0.016).

Conclusions:

• Higher relative dose intensity (RDI) is associated with improved progression-free survival in older lymphoma patients.
• RDI may offer prognostic information beyond traditional factors like age and International Prognostic Index (IPI) risk.
• Prospective validation is needed to confirm the role of RDI in predicting outcomes and guiding treatment intensity in older adults with lymphoma.