Retrospective analysis of frontline treatment efficacy in elderly patients with diffuse large B‐cell lymphoma

Objectives To investigate the effectiveness of 2 chemotherapeutic regimens, bendamustine plus rituximab ( BR ) or reduced‐dose cyclophosphamide, doxorubicin, vincristine, and prednisone plus rituximab (RD‐R‐CHOP), in elderly patients with treatment‐naïve diffuse large B‐cell lymphoma. Methods A retrospective study was conducted to investigate the efficacy and safety of 2 frontline regimens, BR and RD‐R‐CHOP, in patients aged ≥75 years unfit for R‐ CHOP . Results From January 2011 to December 2015, 26 patients received BR and 34 RD‐R‐CHOP. No significant difference was found in clinical background comparisons. The overall response rate was 50% and 79.4% for BR and RD‐R‐CHOP, respectively ( P  =   .027). Compared with patients in RD‐R‐CHOP, those in BR had a lower complete remission rate (42.3% vs 70.6%, P  =   .036), higher progressive disease rate (38.5% vs 8.8%, P  =   .01), and poorer median overall survival (11.2 months vs 39 months, P  =   .035). The prognostic difference was mainly observed in patients with limited stage. By contrast, BR had better toxic profiles. Some patients in BR certainly showed long‐term survivals. Conclusions This study demonstrated better efficacy of RD‐R‐CHOP, indicating its administration might be considered whenever possible, especially for limited stage. However, BR is a reasonable alternative for those ineligible for anthracycline‐containing regimens. Further studies are needed to guide treatment decisions.